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Suggested citation
National Center for Health Statistics.
Health, United States, 2016 is the 40th report on the health leading causes of death, birth rates, cigarette smoking,
status of the nation and is submitted by the Secretary of the obesity, untreated dental caries, diabetes prevalence, and
Department of Health and Human Services to the President uncontrolled hypertension. The third section (Figures 1519)
and the Congress of the United States in compliance with presents trends in health care utilization: use of prescription
Section 308 of the Public Health Service Act. This report drugs, health care and emergency department visits,
was compiled by the Centers for Disease Control and overnight hospital stays, and cancer screening tests. The
Prevention's (CDC) National Center for Health Statistics fourth section (Figures 2022) focuses on changes in health
(NCHS). care resources: hospitals, primary and specialist physicians,
and nursing homes. The fifth section (Figures 2327)
The Health, United States series presents an annual overview describes trends in health care expenditures: personal
of national trends in health statistics. The report contains a health care expenditures, mental health and substance use
Chartbook that assesses the nation's health by presenting expenditures, Medicare managed care enrollment by state,
trends and current information on selected measures of and health insurance coverage.
morbidity, mortality, health care utilization and access,
health risk factors, prevention, health insurance, and Trend Tables
personal health care expenditures. This year's Chartbook
focuses on long-term trends in health. The report also The Chartbook is followed by 114 detailed Trend
contains 114 Trend Tables organized around four major Tables that highlight major trends in health statistics.
subject areas: health status and determinants, health Comparability across editions of Health, United States is
care utilization, health care resources, and health care fostered by including similar Trend Tables in each volume,
expenditures. A companion reportHealth, United States: In and timeliness is maintained by improving the content of
Brieffeatures information extracted from the full report. tables to reflect key topics in public health. An important
The complete report and related data products are available criterion used in selecting these tables is the availability of
on the Health, United States website at: comparable national data over a period of several years.
http://www.cdc.gov/nchs/hus.htm.
Appendixes
The 2016 Edition Appendix I. Data Sources describes each data source used
Health, United States, 2016 contains a summary At a Glance in Health, United States, 2016 and provides references
table that displays recent data on selected indicators of for further information about the sources. Data sources
health and their determinants, cross-referenced to tables in are listed alphabetically within two broad categories:
the report. This is followed by a Highlights section, which Government Sources, and Private and Global Sources.
focuses on both long-term trends and current data on
topics of public health interest and illustrates the breadth Appendix II. Definitions and Methods is an alphabetical
of material included in Health, United States. The other listing of selected terms used in Health, United States, 2016.
major sections are a Chartbook, detailed Trend Tables, two It also contains information on the statistical methodologies
Appendixes, and an Index. The major sections of the 2016 used in the report.
report are described below.
Index
Chartbook The Index to the Trend Tables and Chartbook figures is a
The 2016 Chartbook contains 27 figures on long-term useful tool for locating data by topic. Tables and figures are
trends in health. As Health, United States enters its 40th cross-referenced by such topics as child and adolescent
year of reporting on the health of the nation, this years health; older population aged 65 and over; women's health;
Chartbook focuses on trends in health and health care men's health; state data; American Indian or Alaska Native,
since 1975. Examining long-term trends in health informs Asian, black or African American, Hispanic-origin, and white
the development and implementation of effective health populations; education; injury; disability; and metropolitan
policies and programs. The Chartbook has been grouped and nonmetropolitan data. Many of the Index topics are also
into five sections. The first section (Figures 15) presents an available as conveniently grouped data packages on the
overview of the demographic and socioeconomic factors Health, United States website at:
that have influenced the health of the nation over the last 40 http://www.cdc.gov/nchs/hus.htm.
years. The second section (Figures 614) focuses on health
status and determinants: life expectancy, infant mortality,
Questions?
If you have questions about Health, United States or related
data products, please contact:
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Overall responsibility for planning and coordinating the Additional data and technical assistance were provided
content of this volume rested with the National Center for by the following organizations of the Centers for Disease
Health Statistics (NCHS) Office of Analysis and Epidemiology, Control and Prevention (CDC): National Center for Chronic
under the direction of Julia S. Holmes and Irma E. Arispe. Disease Prevention and Health Promotion: Tara Jatlaoui;
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Production of Health, United States, 2016 was managed by
Prevention: Jim Braxton, Lori Elmore, Anna Satcher Johnson,
Sheila J. Franco, Virginia M. Freid, Julia S. Holmes, and Hashini
Sarah Kidd, Jennifer Ludovic, Rodney Presley, Elizabeth
S. Khajuria. Preparation of the volume, including highlights,
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . vi
Life Expectancy at Birth. . . . . . . . . . . . . . . . . . . . . 16
Natality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
At a Glance Table . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Morbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Uncontrolled Hypertension . . . . . . . . . . . . . . . . . . 24
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Noninstitutionalized Population . . . . . . . . . . . . . . 5
Emergency Departments. . . . . . . . . . . . . . . . . . . . 27
Noninstitutionalized Population . . . . . . . . . . . . . . 6
Use of Mammography and Colorectal Tests
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Noninstitutionalized Population . . . . . . . . . . . . . . 6
Disorder Expenditures . . . . . . . . . . . . . . . . . . . . . 34
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Population Characteristics . . . . . . . . . . . . . . . . . . . . 11
Foreign-Born Population . . . . . . . . . . . . . . . . . . . . 13
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Population by Poverty. . . . . . . . . . . . . . . . . . . . . . 14
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Personnel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Appendixes
Appendix Contents . . . . . . . . . . . . . . . . . . . . . . . . 366
Index
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
19752015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
physicians, by self-designated specialty: United States,
Natality
Figure 9. Birth rates, by age of mother and age at first
Personal Health Care Expenditures
live-birth: United States, 19752015 . . . . . . . . . . . . . . 19
Figure 23. Personal health care expenditures, by source
(preliminary data) . . . . . . . . . . . . . . . . . . . . . . . . . . 36
20112014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Utilization
Figure 15. Prescription drug use in the past 30 days
among adults aged 18 and over, by age and number
of drugs taken: United States, 19881994 through
20132014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Tables 1114
Population (Tables 1 and 2) Personnel (Tables 8388)
Resident population Physicians
Persons in poverty Dentists
Nurses
Fertility and Natality (Tables 39)
Enrollment in health professions schools
Birth rates and more
Low birthweight
Facilities (Tables 8992)
Teenage childbearing
and more Hospitals
Nursing homes
Mortality (Tables 1032)
and more
Infant mortality
National Health Expenditures (Tables 93101)
Life expectancy
Death rates, by cause Health expenditures
and more Out-of-pocket health expenditures
Prescription drug expenditures
Determinants and Measures of Health
Nursing home costs
(Tables 3360)
and more
Health status (respondent-assessed)
Cigarette smoking
Health Care Coverage and Major Federal
Programs (Tables 102111)
Alcohol and other substance abuse
Hypertension Insurance coverage
Overweight and obesity Medicaid
and more Medicare
Private coverage
Ambulatory Care (Tables 6180)
Uninsured
Visits: health care, dentists, emergency departments and more
Prevention: mammograms, pap smears, vaccinations
State Health Expenditures and Health
Inpatient Care (Tables 8182) Insurance (Tables 112114)
Hospital stays and procedures Medicare, Medicaid, managed care expenditures and
enrollees
Uninsured persons
Population age 75, by sex, race, and Hispanic origin: United States,
Table 1. Resident population, by age, sex, race, and selected years 19002015. . . . . . . . . . . . . . . . . . . . 116
Hispanic origin: United States, selected years Table 16. Age-adjusted death rates, by race, Hispanic
Table 2. Persons below poverty level, by selected dependent areas, average annual 19791981,
United States, selected years 19732015 . . . . . . . . . . . 89 Table 17. Age-adjusted death rates for selected causes
19702015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Table 21. Death rates for all causes, by sex, race, Hispanic
20112013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
19502015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
19502015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
selected years 19982015. . . . . . . . . . . . . . . . . . . . 259 selected characteristics: United States, selected years
among adolescents aged 1317, by selected Table 82. Hospital admissions, average length of stay,
characteristics: United States, selected years outpatient visits, and outpatient surgery, by type of
Table 68. Influenza vaccination among adults aged 18 selected years 19752014. . . . . . . . . . . . . . . . . . . . 302
Chronic lower respiratory diseases 44.2 (2000) 40.5 (2014) 41.6 (2015)
Nephritis, nephrotic syndrome, and nephrosis 13.5 (2000) 13.2 (2014) 13.4 (2015)
1
Causes are ordered by the number of deaths in 2015.
2
Having measured high blood pressure (systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90 mm Hg) and/or respondent report of taking
antihypertensive medication.
3
Includes physician-diagnosed and undiagnosed diabetes (fasting plasma glucose of at least 126 mg/dL or a hemoglobin A1c of at least 6.5%).
4
Having high serum total cholesterol of 240 mg/dL or greater and/or respondent report of taking cholesterol-lowering medication.
5
Obesity is a body mass index (BMI) greater than or equal to 30 for adults. Height and weight are measured rather than self-reported.
6
Federal guidelines recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity a week and muscle-
strengthening activities at least twice a week.
7
Copyright 2016. Used with permission of Health Forum LLC, an affiliate of the American Hospital Association.
NOTES: Estimates in this table are taken from the PDF, printed, or spreadsheet version of the cited tables. For more information and the spreadsheet version of the
tables, see the Health, United States website: http://www.cdc.gov/nchs/hus/index.htm.
This Highlights section includes data from the four major Despite declines in infant mortality for all racial and ethnic
areas included in the report: health status and determinants, groups, infants of non-Hispanic black mothers (10.93 infant
utilization of health resources, health care resources, and deaths per 1,000 live births) had the highest infant mortality
health care expenditures and payers. As Health, United States rates compared with the other racial and ethnic groups in
enters its 40th year of reporting on the health of the nation, 2014 (Figure 7 and Table 10).
this years Highlights section presents trends in health from
1975 or the earliest year possible, given data availability Between 1975 and 2015, the age-adjusted heart disease
and comparability issues. The Highlights focus on both death rate decreased 61% from 431.2 to 168.5 deaths per
trends and current data on topics of public health interest 100,000 population; and the age-adjusted cancer death
and illustrate the breadth of material included in Health, rate decreased 21% from 200.1 to 158.5 deaths per 100,000
United States. Each highlight includes a reference to the population. Throughout 19752015, heart disease and
detailed trend table or figure where definitions of terms and cancer were the first and second leading causes of death.
additional data can be obtained. In 2015, these two causes accounted for 45% of all deaths
(Figure 8 and Table 19).
Health Status and Determinants The age-adjusted drug poisoning death rate involving
opioid analgesics increased from 1.4 to 5.4 deaths per
Life Expectancy and Mortality 100,000 population between 1999 and 2010, decreased to
5.1 in 2012 and 2013, then increased to 5.9 in 2014, and to
Between 1975 and 2015, life expectancy at birth increased 7.0 in 2015. The age-adjusted drug poisoning death rate
from 72.6 to 78.8 years for the total U.S. population. For involving heroin doubled from 0.7 to 1.4 deaths per 100,000
males, life expectancy increased from 68.8 years in 1975 to resident population between 1999 and 2011 and then
76.3 years in 2015, and for females, life expectancy increased continued to increase to 4.1 in 2015 (Table 27).
from 76.6 years in 1975 to 81.2 years in 2015 (Table 15).
In 2015, the 10 leading causes of death were heart disease,
Life expectancy at birth decreased 0.1 years overall between cancer, chronic lower respiratory diseases, unintentional
2014 and 2015. For males, life expectancy declined 0.2 injuries, stroke, Alzheimers disease, diabetes, influenza and
years from 76.5 years in 2014 to 76.3 years in 2015, and for pneumonia, kidney disease, and suicide. These 10 causes of
females, life expectancy decreased 0.1 years, from 81.3 years death accounted for 74% of the 2.7 million deaths in 2015
in 2014 to 81.2 years in 2015 (Table 15). (Figure 8 and Table 19).
Between 1975 and 2015, life expectancy at birth increased Between 2014 and 2015, age-adjusted death rates increased
more for the black than for the white population, thereby for eight of the ten leading causes. The only decrease in
narrowing the gap in life expectancy between these two age-adjusted death rates among the 10 leading causes of
racial groups. In 1975, life expectancy at birth for the death between 2014 and 2015 was for cancer; the rate for
white population was 6.6 years longer than for the black influenza and pneumonia did not change significantly
population; by 2015, the difference had narrowed to 3.5 (Table 17).
years (Figure 6).
Between 2014 and 2015, the age-adjusted suicide death rate
Between 2014 and 2015, life expectancy at birth was stable increased 2%, from 13.0 to 13.3 deaths per 100,000 resident
at 82.0 years for Hispanic persons, decreased 0.2 years to population. Among adolescents and adults aged 1524,
78.7 years for non-Hispanic white persons, and decreased suicide death rates increased 8% between 2014 and 2015
0.2 years to 75.1 years for non-Hispanic black persons (Table 30).
(Table 15).
Between 1975 and 2015, the infant mortality rate decreased Fertility and Natality
63%, from 16.07 to 5.90 deaths per 1,000 live births and the
neonatal mortality rate (among infants under age 28 days) Between 1975 and 2015, the birth rate among teenagers
decreased 66%, from 11.58 to 3.93. Between 1975 and 2015, aged 1519 fell 60%, from 55.6 to 22.3 live births per 1,000
the postneonatal mortality rate (among infants aged 28 femalesa record low for the United States (Figure 9).
days through 11 months) decreased 56%, from 4.49 to 1.96
(Figure 7). In 1975, 7.38% of infants were low-birthweight (weighing
less than 2,500 grams [5.5 pounds] at birth) compared with
8.07% in 2015. Low-birthweight was more common among
Health Risk Factors for the From 19881994 to 20112014, the age-adjusted
Noninstitutionalized Population percentage of adults aged 20 and over with hypertension
who had uncontrolled high blood pressure decreased for
Children both men (83.2% to 58.1%) and women (68.5% to 45.5%).
From 19881994 to 20032004, the percentage of children Throughout the period, among those with hypertension,
and adolescents aged 219 with obesity increased from men had a higher percentage with uncontrolled blood
10.0% to 17.1%, and then was stable from 20032004 to pressure than women (Figure 14 and Table 54).
20132014. The percentage of children and adolescents with
obesity was 17.2% in 20132014 (Figure 11). Between 19881994 and 20112014, the age-adjusted
prevalence of total diabetes among adults aged 20 and over
In 2015, 4.2% of adolescents aged 1217 reported smoking increased from 8.8% to 11.9%. In both time periods, the age-
cigarettes in the past month. Smoking prevalence has adjusted prevalence of total diabetes was higher among
declined since 2002, when 13.0% of adolescents reported non-Hispanic black and Mexican origin adults compared
smoking cigarettes in the past month (Table 50). with non-Hispanic white adults (Figure 13 and Table 40).
Between 1974 and 2015, the age-adjusted prevalence of Between 1975 and 2015, the percentage of males and
current cigarette smoking declined from 36.9% to 15.6% females under age 75 with an overnight hospital stay in the
among persons aged 25 and over. Current cigarette smoking prior 12 months declined, while remaining stable among
declined as educational attainment increased, from 25.6% those aged 75 and over. Hospitalization use generally
of adults aged 25 and over without a high school diploma or increased with age, from 2.1% of boys and girls aged under
GED to 5.9% of those with a Bachelor's degree or higher in 18 to 20.3% of men and 17.7% of women aged 75 and over
2015 (Figure 10 and Table 48). in 2015 (Figure 18).
Between 1995 and 2015, the U.S. nursing home occupancy Health Insurance Coverage for the
rate decreased from 84.5% to 80.3%. In 2015, nursing home Noninstitutionalized Population
occupancy rates were highest in North Dakota (92.7%), the
District of Columbia (91.8%), Rhode Island (91.4%), and Between 1978 and September 2016 (preliminary estimates),
South Dakota (91.4%). The lowest occupancy rates in 2015 the percentage of children under age 18 with Medicaid
were in Oregon (60.1%), Utah (63.9%), Indiana (64.3%), and coverage increased from 11.3% to 39.2% and the percentage
Idaho (64.9%) (Table 92). of children who were uninsured decreased from 12.0% to
Figure 1. Population, by sex and five-year age groups: United States, 1975 and 2015
Total population: 216.0 million Total population: 321.4 million
85+
1975 2015
8084 Male
Female
7579
7074
6569
6064
5559
5054
Age (years)
4549
4044
3539
3034
2529
2024
1519
1014
59
04
12 10 8 6 4 2 0 2 4 6 8 10 12 12 10 8 6 4 2 0 2 4 6 8 10 12
Percent Percent
NOTES: Resident Population. See data table for Figure 1. SOURCE: U.S. Census Bureau 1975 intercensal estimates of the July 1, 1975 resident
population; 2015 postcensal estimates of the July 1, 2015 resident population.
Figure 2. Population, by race and Hispanic origin and age: United States, 1980, 1990, 2000, and 2015
60 13.8
0
1980 1990 2000 2015 1980 1990 2000 2015 1980 1990 2000 2015
White only, not Hispanic Black only, not Hispanic Hispanic Asian only, not Hispanic All other races, not Hispanic
NOTES: Resident population. Persons of Hispanic origin may be of any race. Race data for
2000 and 2015: Data were tabulated based on the 1997 Standards with five single
2000 and 2015 are not directly comparable with data from 1980 and 1990 because of the race groups and the option to report more than one race. Non-Hispanic All other races
use of different Standards for classifying race. includes non-Hispanic Native Hawaiian or Other Pacific Islander only, non-Hispanic
American Indian or Alaska Native only, and non-Hispanic multiple race (shown
1980 and 1990: Data were tabulated based on the 1977 Standards with four single race combined in the chart due to small numbers and displayed separately in the data table).
categories; the category non-Hispanic Asian only includes non-Hispanic Pacific Islander See data table for Figure 2.
only persons. Non-Hispanic All other races includes non-Hispanic American Indian or
Alaska Native only. SOURCE: U.S. Census Bureau decennial estimates 1980, 1990, and 2000; postcensal
estimates 2015.
Since 1970, the foreign-born share of the population residing in socioeconomic circumstances, immigration statuses, and
the United States has nearly tripled, increasing from 4.7% of the federal and state policies related to access to health care (24).
population to 13.5% of the population in 2015.
Since 1970, the foreign-born share of the population residing
The increasing racial and ethnic diversity in the U.S. in the United States has nearly tripled, from 4.7% to 13.5%
population is due in part to the immigrant population who in 2015. The distribution of country of origin of immigrants
are more likely to be from racial and ethnic minority groups. has changed between 1970 and 2015. In 1970, 61.7% of
Foreign-born immigrants are often younger and healthier immigrants living in the U.S. were from Europe, 19.4% were
than native-born Americans, explained in part by the healthy from Latin America, and 8.9% were from Asia. By 2015,
immigrant effectthat those who immigrate are healthier European immigrants made up a smaller share of the foreign-
than those who do not (22,23). However, addressing the born population (11.1%), while Latin Americans accounted for
health and health care needs of an increasingly diverse more than one-half (51.1%) and Asians accounted for nearly
immigrant population can be challenging given different one-third (30.6%) of all immigrants.
10.0 8.9
15
19.4
13.5 1970
12.9
61.7
11.1
Percent
10
7.9
7.3
6.2 11.1
30.6
5 4.7
2015
51.1
0
1970 1980 1990 2000 2010 2015
NOTES: Resident population for 19702000 and civilian noninstitutionalized population SOURCE: U.S. Census Bureau, Decennial Census 19702000; American Community
for 2010 and 2015. The foreign-born population includes anyone who is not a U.S. citizen Survey (ACS) 2010 and 2015.
at birth (including naturalized citizens, lawful permanent residents, temporary migrants,
humanitarian migrants, and undocumented migrants) among those with region of birth
reported. Region of origin Other includes Africa, Oceania, and Northern America. See
data table for Figure 3.
Figure 4. Population, by percent of poverty level and age: United States, 19752015
40
Percent below 100% of poverty level Percent of poverty level: 2015
20
Male 10.5 15.0
65 years and over
Female 14.2 16.4
10
65 years and over 8.8 22.3
18-64 years
Below 100%
Male 7.0 19.0 100%199%
NOTES: Percent of poverty level is based on family income and family size and SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic
composition using U.S. Census Bureau poverty thresholds. See data table for Figure 4 Supplements.
Figure 5. Population, by urbanization level: United States, 1970, 1980, 1990, 2000, and 2015
100
6.9 5.9
14.4
20.3 17.4 8.5
26.8 27.8 10.5
80 9.1
9.5
8.0
8.6 9.1 20.9
19.7
Percent distribution
60 21.9
22.9 23.3
24.8
40 19.4 23.4
12.3
12.9
20
29.4 30.4 29.9 30.8
26.9
0
1970 1980 1990 2000 2015
Large central (inner cities) Large fringe (suburbs) Medium Small Micropolitan (city/town) Noncore (most rural)
Metropolitan (urban) Nonmetropolitan (rural)
NOTES: The categories micropolitan and noncore were not used in 1970, 1980, and 1990; SOURCE: U.S. Census Bureau; 1970 and 1980 data from Department of Agriculture
therefore, total nonmetropolitan population is shown. See data table for Figure 5. Economic Research Service reports.
Figure 6. Life expectancy at birth, by sex, race and Hispanic origin: United States, 19752015
100
2015
Hispanic or Latino
White, not Hispanic
Black, not Hispanic
Male
White female
80
Life expectancy (years)
79.3
Black female
76.3
84.3
81.1
78.1
0
1975 1980 1985 1990 1995 2000 2005 2010 2015 0 20 40 60 80 100
Life expectancy (years)
NOTES: Life expectancy data by Hispanic origin were available starting in 2006 and were SOURCE: NCHS, National Vital Statistics System (NVSS).
corrected to address racial and ethnic misclassification. Life expectancy estimates for
white and black persons in 2014 and 2015 are based on preliminary Medicare data. See
data table for Figure 6.
Figure 7. Infant mortality rates, by infant age at death and race and Hispanic origin of mother: United States, 19752015
18
Infant, neonatal, and postneonatal mortality rates: Infant mortality rates, by race and Hispanic origin:
19752015 2014
16
14
Infant deaths per 1,000 live births
Infant
12
10.93
10
Neonatal
8 7.66
6
4.89 5.01
Postneonatal
4 3.68
0
White, not Black, not American Asian or Hispanic
1975 1985 1995 2005 2015 Hispanic Hispanic Indian or Pacific
Alaska Islander,
Native, not
not Hispanic
Hispanic
NOTES: Infant (under 1 year of age), neonatal (under 28 days), and postneonatal (28 SOURCE: NCHS, National Vital Statistics System (NVSS).
days11 months) rates are based on the number of deaths from the mortality file and
the number of births from the natality file. Infant mortality rates by race and Hispanic
origin are from the Linked Birth/Infant Death data set, in which the most recent data
available is 2014. See data table for Figure 7.
Figure 8. Leading causes of death in 1975 and 2015: United States, 19752015
100
Age-adjusted death rates for the top 5 leading Top 10 leading causes of death, 2015
causes of death, 1975 and 2015
90
Deaths per 100,000 resident population (log scale)
NOTES: Underlying causes of death are based on the International Classification of rules changed starting in 1999 resulting in a decreased number of deaths coded to the
Diseases, 8th Revision (ICD8) for 19751978, ICD9 for 19791998, and ICD10 for 1999 cause. See data table for Figure 8.
2015. Due to coding changes for chronic lower respiratory diseases (CLRD) between
ICD9 and ICD10, which prevent the direct comparison of trends prior to 1998 and after SOURCE: NCHS, National Vital Statistics System (NVSS).
1999, rates for CLRD are only shown for 1999 onwards. Influenza and Pneumonia coding
Figure 9. Birth rates, by age of mother and age at first live-birth: United States, 19752015
140
Birth rates, by age of mother: 19752015 Maternal age at first live-birth, by race and Hispanic
origin of mother: 2015
120 2529 years
1.8 1.4 1.3 0.9 3.2
100
5.3 5.5 3.3
8.5 8.9
90 13.3
100 12.6 13.7
Live births per 1,000 women
80
24.6 20.0
3034 years
70 21.8 22.7
Percent distribution
80 36.0
2024 years 60
50 31.0
60 39.7
40 39.4 35.6
1519 years
30 33.0
40
20 25.1
3539 years 27.3
10 19.5 21.2
20 2.4 12.2
9.1
4044 years 0
White, not Black, not Hispanic American Asian
0 Hispanic Hispanic Indian or or Pacific
Alaska Islander,
1975 1985 1995 2005 2015 Native, not
not Hispanic
Hispanic
Less than 20 years 2024 years 2529 years
NOTE: See data table for Figure 9.
3034 years 3539 years 40 years and over
Figure 10. Cigarette smoking among adults aged 25 years and over, by sex and education level: United States, 19742015
60
Men Women
40
No high school diploma
High school diploma or GED
Percent
30
20
Some college Some college
0
1974 1979 1985 1990 1995 2000 2005 2010 2015 1974 1979 1985 1990 1995 2000 2005 2010 2015
NOTES: Current cigarette smokers are defined as ever smoking 100 cigarettes in their SOURCE: NCHS, Health, United States, 2016, Table 48. Data from the National Health
lifetime and now smoke every day or some days. Educational categories shown are Interview Survey (NHIS).
for 1997 and subsequent years. GED is General Educational Development high school
equivalency diploma. Prior to 1997, the educational categories were less than 12 years
completed, 12 years completed, 1315 years, 16 years or more. Estimates are age-
adjusted. See data table for Figure 10.
Figure 11. Obesity among children and adolescents aged 219 and adults aged 20 years and over: United States,
19881994 through 20132014
50 50
219 years 20 years and over
45 45
40 40
35 35
Percent (age-adjusted)
30 30
Obesity
Percent
25 25
20 20
Grade 1 obesity
15 15
Obesity
10 10 Grade 2 obesity
5 5
Grade 3 obesity
0 0
1988 1999 2013 1988 1999 2013
1994 2000 2014 1994 2000 2014
NOTES: For children and adolescents aged 219, obesity is defined as a body mass index 34.9; grade 2 obesity is a BMI from 35.0 to 39.9; and grade 3 obesity is a BMI greater than
(BMI) at or above the sex- and age-specific 95th percentile of the CDC growth charts. For or equal to 40.0. Estimates for adults are age-adjusted. See data table for Figure 11.
adults, obesity is defined as a BMI at or above 30; grade 1 obesity is a BMI from 30.0 to
SOURCE: NCHS, National Health and Nutrition Examination Survey (NHANES).
Figure 12. Untreated dental caries among children and adolescents aged 519 years and adults aged 20 and over,
by percent of poverty level: United States, 19881994, 19992004, and 20112014
60 60
519 years 20 years and over
50 48.6 49.7
Below 100% 200%399% 50
100%199% 400% or more
44.1
42.3 41.5
40 39.0 40 37.9
Percent (age-adjusted)
32.2 32.1
Percent
30 29.6
30
25.7 26.8
24.7 24.7
22.3
20 18.9 20
16.6 16.0
13.5 13.3
12.2
10.4* 10.0
10 9.1 10
0 0
19881994 19992004 20112014 19881994 19992004 20112014
* Relative standard error (RSE) of 20%30%. evaluated in primary and permanent teeth for persons aged 5 and over. Persons
who were classified as edentulous were excluded. See data table for Figure 12.
NOTES: Estimates for adults are age-adjusted. Untreated dental caries refers to decay on
the crown or enamel surface of a tooth (i.e., coronal caries) that has not been treated or SOURCE: NCHS, National Health and Nutrition Examination Survey (NHANES).
filled. Decay in the root (i.e., root caries) was not included. The presence of caries was
Figure 13. Diabetes prevalence among adults aged 20 years and over, by diagnosis status and race and Hispanic origin:
United States, 19881994 and 20112014
20
Total diabetes 18.0 18.0
18
Undiagnosed diabetes
16.3 16.3
Physician-diagnosed diabetes 15.6
16 4.6 5.1
14
5.9
Percent (age-adjusted)
2.9 9.6
10
8.8
7.7 2.0
8
3.6 13.4 13.0
6 2.9
10.4 10.7
9.0 9.1
4 7.6
5.2 4.8
2
0
1988 2011 1988 2011 1988 2011 1988 2011 1988 2011
1994 2014 1994 2014 1994 2014 1994 2014 1994 2014
All persons White, not Hispanic Black, not Hispanic Asian, not Hispanic Mexican origin
Estimates are not available for non-Hispanic Asian persons in 19881994. SOURCE: NCHS, National Health and Nutrition Examination Survey (NHANES).
NOTES: Estimates are age-adjusted. See Appendix II, Diabetes. See data table for
Figure 13 and Table 40.
Figure 14. Uncontrolled high blood pressure among adults aged 20 and over with hypertension, by sex and age:
United States, 19881994 through 20112014
100 100
20112014
90 90 2034 3544 4564 6574 75 and over
Men
80 Total 80
74.1
70 Women 70
64.2
Percent (age-adjusted)
61.5
60 60
55.5
49.7
50 50
Percent
46.5
44.5
40 40 38.2 37.7 36.8
30 30
20 20
10 10
0 0
1988 1999 2003 2007 2011 Men Women
1994 2002 2006 2010 2014
NOTES: Uncontrolled high blood pressure among persons with hypertension is defined SOURCE: NCHS, National Health and Nutrition Examination Survey (NHANES).
as measured systolic pressure of at least 140 mm Hg or diastolic pressure of at least
90 mm Hg, among those with measured high blood pressure or reporting taking
antihypertensive medication. Estimates for the left figure are age-adjusted. See data
table for Figure 14.
Figure 15. Prescription drug use in the past 30 days among adults aged 18 and over, by age and number of drugs taken:
United States, 19881994 through 20132014
100
Use of at least one prescription drug Prescription drug use in the past 30 days,
in the past 30 days, by age by age and number of drugs taken 90.8
49.4 59.9
40 36.5
1844 years
31.3 47.5
32.6 42.2
20
30.1
20.2
1.2 13.8
3.9 7.4
Figure 16. Health care visits in the past 12 months among children aged 217 and adults aged 18 and over, by age and
provider type: United States, 1997, 2006, and 2015
Figure 17. Emergency department visits in the past 12 months for persons under age 65, by age and type of coverage:
United States, 19972015
50
Under 18 years 1864 years
45
Medicaid
40
35
Percent with 1 or more visits
Medicaid
30
25
Uninsured
Uninsured
20
15
Private Private
10
0
1997 2015 1997 2015
NOTE: See data table for Figure 17. SOURCE: NCHS, National Health Interview Survey (NHIS).
Figure 18. Overnight hospital stays in the past 12 months, by sex and age: United States, 19752015
30
Male Female
6574 years
20
6574 years
4564 years
1844 years
10
1844 years
4564 years
0
1975 1980 1985 1990 1995 2000 2005 2010 2015 1975 1980 1985 1990 1995 2000 2005 2010 2015
NOTES: Hospitalizations include those relating to deliveries. Because persons who had a survey of hospital discharges. The difference will be larger for older persons. See data
hospitalization and subsequently died or were institutionalized are not included in the table for Figure 18.
National Health Interview Survey, the estimates shown will vary from those based on a
SOURCE: NCHS, National Health Interview Survey (NHIS).
Figure 19. Mammography use and colorectal cancer testing use, by race and Hispanic origin: United States,
selected years 19872015
100
Use of mammography in the past 2 years among women Use of any colorectal test or procedure among adults
aged 4074: United States, selected years 19872015 aged 5075: United States, selected years 20002015
90
Hispanic
70
Percent
10
0
1987 1990 1993 1998 2003 2008 2013 2015 2000 2003 2005 2008 2010 2013 2015
NOTES: Prior to 1999, data were tabulated according to the 1977 Standards with four and procedures may be used for diagnostic or screening purposes. It is not possible to
racial groups, and the Asian category included Native Hawaiian or Other Pacific Islander. determine the purpose of the test in NHIS. See data table for Figure 19.
Mammography data for Asian only, not Hispanic in 1987 are not shown because they
are unreliable. Data for colorectal testing are presented starting in 2000 due to changes SOURCE: NCHS, National Health Interview Survey (NHIS).
in available examinations prior to 2000. Mammograms and colorectal cancer testing
Figure 20. Community hospital beds, average length of stay, and occupancy rate: United States, selected years 19752014
10 10 100
Hospital beds Average length of stay Occupancy rate
9 9
8 8 80
Beds per 1,000 resident population
7.7
75.0
7.1
7 7 67.3
6.5 64.8
62.8 62.8
Residents per 100 beds
Inpatient days
6 6 5.6 60
5.5
5 4.6 5
4.2
4 4 40
3.3
3 2.7 3
2.5
2 2 20
1 1
0 0 0
1975 1985 1995 2005 2014 1975 1985 1995 2005 2014 1975 1985 1995 2005 2014
NOTE: See data table for Figure 20. SOURCE: American Hospital Association (AHA) [Reprinted from AHA Hospital Statistics
by permission, Copyright 1976, 1986, 1998, 2007, and 2016 by Health Forum, LLC, an
American Hospital Association Company].
Figure 21. Active primary care generalist and specialist physicians, by self-designated specialty: United States,
selected years 19752013
30 100
25
80
Percent distribution of active physicians
15
Specialist physician
40
10
42.6 41.1
Primary care generalist physician 20
40.1 39.0 38.6 39.7 39.4 38.3 37.4
5
0 0
1975 1980 1985 1990 1995 2000 2005 2010 2013 1975 1980 1985 1990 1995 2000 2005 2010 2013
Primary care generalist physician Specialist physician
NOTES: Primary care generalist physicians include family medicine, internal medicine, SOURCE: American Medical Association (AMA) [Copyright 1976, 1982, 1986, 1992, 1997,
obstetrics and gynecology, and pediatrics. Specialists include all other specialties and 2003, 2007, 2012, and 2015: Used with permission of the AMA].
primary care subspecialists. Excludes physicians who are inactive, and physicians who
did not provide generalist/specialist information. See data table for Figure 21.
Figure 22. Nursing home beds, residents, and occupancy rate: United States, selected years 19772014
70 70 110
Beds Residents Occupancy rate
100
92.9
Nursing home residents per 100 nursing home beds
59.7 91.8
Nursing home residents aged 65 and over per 1,000
60 60
56.9 90 87.4 86.3
resident population aged 65 years and over
52.6 82.3
Nursing home beds per 1,000 resident
population aged 65 years and over
80
50 47.7 50 47.1
46.2
70
41.3
40 40
36.0 36.3 60
50
30 30
25.2 40
20 20 30
20
10 10
10
0 0 0
1977 1985 1995 2004 2014 1977 1985 1995 2004 2014 1977 1985 1995 2004 2014
NOTE: See data table for Figure 22. SOURCE: NCHS, National Nursing Home Survey (NNHS) for 1977, 1985, 1995, and 2004
data; National Study of Long-Term Care Providers (NSLTCP) for 2014.
Figure 23. Personal health care expenditures, by source of funds and type of expenditure: United States, 1975, 1995,
and 2015
100
Source of funds 10.6 Type of expenditure
14.0 12.2 12.5 13.2
17.5 0.5
7.1 3.7 3.3
80 12.4 5.8
7.4
16.7 7.1
5.1 4.3
6.7 7.1
32.9 6.3 6.9 11.9
Percent distribution
11.6
60
9.4
22.4
25.3
23.4
5.1 22.3
20.7 Other
40 6.2
Home health care
Nursing care facilities
13.8 and continuing
Other
care retirement
Out of pocket 45.3 communities
20 Medicaid (state) 39.0 38.1 Dental
33.0 34.8
Medicaid (federal) Prescription drugs
24.5
Medicare Physician and clinical
Private insurance Hospital
0
NOTES: Personal health care expenditures are outlays for goods and services relating care expenditures are in current dollars and are not adjusted for inflation. See data table
directly to patient care. Other sources include Department of Defense, Department for Figure 23.
of Veterans Affairs, and other third party payers and programs. Medicaid includes
expenditures for the Childrens Health Insurance Program (CHIP). Other types of SOURCE: Centers for Medicare & Medicaid Services, National Health Expenditures
expenditures include other professional services; other health, residential, and personal Accounts (NHEA).
care; and durable and nondurable medical equipment and products. Personal health
Mental health and substance use disorders are serious, In 2014, $34 billion was spent on substance use disorder
potentially disabling or fatal, and costly on a personal and treatment, representing 1.2% of all health spending*.
societal level (98101; Tables 27 and 30). Mental illness and Between 1986 and 2014, the share of substance use disorder
substance use disorders affect a significant segment of the expenditures paid for inpatient care decreased from 50%
U.S. population (102,103). Mental health and substance use to 19%; outpatient treatment increased from 27% to 40%;
disorders are amenable to treatment (104107), however, residential treatment increased from 17% to 27%; and retail
treatment can be costly and not always readily available prescription drug spending increased from less than 1%
(108113). The Paul Wellstone and Pete Domenici Mental to 5%.
Health Parity and Addiction Equity Act of 2008 (114) and the
ACA (115) included provisions to expand access to mental
health and substance abuse coverage and treatment. In *All health spending is defined here as health consumption
2013, 14.6% of noninstitutionalized adults received any type expenditures (national health expenditures minus
of mental health treatment and 1.3% received any type of investments for structures and research). See Table 94.
substance use treatment (102).
Figure 24. Mental health and substance use disorder expenditures, by type of expenditure: United States,
selected years, 19862014
60
Mental health expenditures ($186 Billion, 2014) Substance use disorder expenditures ($34 Billion, 2014)
50
Inpatient care
Outpatient care
Inpatient care
40
Outpatient care
Percent
30
20
Residential care
10
Residential care
Retail prescription drugs
Retail prescription drugs
0
1986 1992 1998 2004 2009 2014 1986 1992 1998 2004 2009 2014
NOTE: See data table for Figure 24. SOURCE: Substance Abuse and Mental Health Services Administration (SAMHSA),
Behavioral Health Spending and Use Accounts (BHSUA).
30
Percent of enrollees
DC
Managed care enrollees
20
0
1994 2014
NOTE: See data table for Figure 25. SOURCE: Centers for Medicare & Medicaid Services, Medicare Administrative Data.
Figure 26. Health insurance coverage among children under age 18, by type of coverage: United States,
selected years 1978September 2016 (preliminary data)
100
80
Private health insurance (total)
60
Private health insurance through workplace
Percent
40
0
1978 1982 1986 1990 1994 1998 2002 2006 2010 2014 2016
JanSep
NOTES: Preliminary estimates for the first 9 months of 2016 are shown with a dashed or a professional association. The Medicaid category includes the Childrens Health
line (130,131). Health insurance coverage, definitions, and questionnaires have changed Insurance Program (CHIP), which was enacted in 1997. Persons classified with Private or
over time. Insurance status is at the time of interview except for 19901996, when it is Medicaid coverage may also have other types of coverage. See data table for Figure 26.
for the month prior to interview. Private workplace coverage includes private coverage
originally obtained through a present or former employer or union, self-employment, SOURCE: NCHS, National Health Interview Survey (NHIS).
Figure 27. Health insurance coverage among adults aged 1864, by type of coverage: United States,
selected years 1978September 2016 (preliminary data)
100
40
20
Uninsured
0
1978 1982 1986 1990 1994 1998 2002 2006 2010 2014 2016
JanSep
NOTES: Preliminary estimates for the first 9 months of 2016 are shown with a dashed a professional association. Medicaid includes the Childrens Health Insurance Program
line (130,131). Health insurance coverage, definitions, and questionnaires have changed (CHIP), which was enacted in 1997. Persons classified with Private or Medicaid coverage
over time. Insurance status is at the time of interview except for 19901996, when it is may also have other types of coverage. See data table for Figure 27.
for the month prior to interview. Private workplace coverage includes private coverage
originally obtained through a present or former employer or union, self-employment, or SOURCE: NCHS, National Health Interview Survey (NHIS).
Data table for Figure 1 (page 1 of 2). Population, by sex and five-year age groups: United States, 1975 and 2015
Excel and PowerPoint: http://www.cdc.gov/nchs/hus/contents2016.htm#fig01
Year and age group Both sexes Male Female
1975 Percent
04 years . . . . . . . . . . . . . . . . . . . 7.5 7.8 7.1
59 years . . . . . . . . . . . . . . . . . . . 8.1 8.5 7.8
1014 years . . . . . . . . . . . . . . . . . . 9.6 10.0 9.1
1519 years . . . . . . . . . . . . . . . . . . 9.9 10.3 9.5
2024 years . . . . . . . . . . . . . . . . . . 9.0 9.3 8.8
2529 years . . . . . . . . . . . . . . . . . . 8.0 8.2 7.8
3034 years . . . . . . . . . . . . . . . . . . 6.6 6.7 6.5
3539 years . . . . . . . . . . . . . . . . . . 5.4 5.4 5.4
4044 years . . . . . . . . . . . . . . . . . . 5.2 5.2 5.2
4549 years . . . . . . . . . . . . . . . . . . 5.5 5.4 5.5
5054 years . . . . . . . . . . . . . . . . . . 5.5 5.4 5.6
5559 years . . . . . . . . . . . . . . . . . . 4.9 4.8 5.1
6064 years . . . . . . . . . . . . . . . . . . 4.4 4.1 4.5
6569 years . . . . . . . . . . . . . . . . . . 3.8 3.4 4.1
7074 years . . . . . . . . . . . . . . . . . . 2.7 2.3 3.0
7579 years . . . . . . . . . . . . . . . . . . 2.0 1.6 2.3
8084 years . . . . . . . . . . . . . . . . . . 1.3 0.9 1.6
85 years and over . . . . . . . . . . . . . . . 0.8 0.6 1.1
2015
04 years . . . . . . . . . . . . . . . . . . . 6.2 6.4 6.0
59 years . . . . . . . . . . . . . . . . . . . 6.4 6.6 6.1
1014 years . . . . . . . . . . . . . . . . . . 6.4 6.6 6.2
1519 years . . . . . . . . . . . . . . . . . . 6.6 6.8 6.3
2024 years . . . . . . . . . . . . . . . . . . 7.1 7.4 6.8
2529 years . . . . . . . . . . . . . . . . . . 7.0 7.2 6.8
3034 years . . . . . . . . . . . . . . . . . . 6.7 6.9 6.6
3539 years . . . . . . . . . . . . . . . . . . 6.3 6.4 6.3
4044 years . . . . . . . . . . . . . . . . . . 6.3 6.3 6.2
4549 years . . . . . . . . . . . . . . . . . . 6.5 6.5 6.4
5054 years . . . . . . . . . . . . . . . . . . 6.9 6.9 7.0
5559 years . . . . . . . . . . . . . . . . . . 6.8 6.7 6.9
6064 years . . . . . . . . . . . . . . . . . . 5.9 5.8 6.1
6569 years . . . . . . . . . . . . . . . . . . 5.0 4.8 5.2
7074 years . . . . . . . . . . . . . . . . . . 3.6 3.3 3.8
7579 years . . . . . . . . . . . . . . . . . . 2.5 2.3 2.8
8084 years . . . . . . . . . . . . . . . . . . 1.8 1.5 2.1
85 years and over . . . . . . . . . . . . . . . 2.0 1.4 2.5
See footnotes at end of table.
SOURCE: U.S. Census Bureau 1975 intercensal estimates of the July 1, 1975 resident population; 2015 postcensal estimates of the July 1, 2015 resident population.
See Appendix I. Population Census and Population Estimates.
In 1980 and 1990, data were tabulated based on the 1977 Standards with four single race categories; the category non-Hispanic Asian only includes non-Hispanic
Pacific Islander only persons. Non-Hispanic All other races includes non-Hispanic American Indian or Alaska Native only.
In 2000 and 2015, data were tabulated based on the 1997 Standards with five single race groups and the option to report more than one race. Non-Hispanic All
other races includes non-Hispanic Native Hawaiian or Other Pacific Islander only, non-Hispanic American Indian or Alaska Native only, and non-Hispanic multiple
race (shown combined in the chart due to small numbers and displayed separately in the data table). See Appendix I, Population Census and Population Estimates,
Appendix II, Hispanic origin; Race.
NOTES: Resident population. Persons of Hispanic origin may be of any race. Race data for 2000 and 2015 are not directly comparable with data from 1980 and 1990
because of the use of different Standards for classifying race.
SOURCE: U.S. Census Bureau decennial estimates 1980, 1990, and 2000; postcensal estimates 2015. See Appendix I. Population Census and Population Estimates.
1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7
1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2
1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9
2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.5
Year and region of origin
1970
Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9
Latin America . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4
Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61.7
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.0
2015
Asia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.6
Latin America . . . . . . . . . . . . . . . . . . . . . . . . . . 51.1
Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3
NOTES: Resident population for 19702000 and civilian noninstitutionalized population for 2010 and 2015. The foreign-born population includes anyone who is not a
U.S. citizen at birth (including naturalized citizens, lawful permanent residents, temporary migrants, humanitarian migrants, and undocumented migrants) among those
with region of birth reported. Region of origin Other includes Africa, Oceania, and Northern America. For a list of countries and dependencies included under Latin
America, see https://www.census.gov/content/dam/Census/library/publications/2011/acs/acsbr10-15.pdf.
SOURCE: U.S. Census Bureau, Decennial Census 19702000; American Community Survey (ACS) 2010 and 2015. See Appendix I, American Community Survey (ACS);
Population Census and Population Estimates.
Percent
1975 . . . . . . . . . . . . . . . . . . . . . . 17.1 9.2 15.3
1976 . . . . . . . . . . . . . . . . . . . . . . 16.0 9.0 15.0
1977 . . . . . . . . . . . . . . . . . . . . . . 16.2 8.8 14.1
1978 . . . . . . . . . . . . . . . . . . . . . . 15.9 8.7 14.0
1979 . . . . . . . . . . . . . . . . . . . . . . 16.4 8.9 15.2
1980 . . . . . . . . . . . . . . . . . . . . . . 18.3 10.1 15.7
1981 . . . . . . . . . . . . . . . . . . . . . . 20.0 11.1 15.3
1982 . . . . . . . . . . . . . . . . . . . . . . 21.9 12.0 14.6
1983 . . . . . . . . . . . . . . . . . . . . . . 22.3 12.4 13.8
1984 . . . . . . . . . . . . . . . . . . . . . . 21.5 11.7 12.4
1985 . . . . . . . . . . . . . . . . . . . . . . 20.7 11.3 12.6
1986 . . . . . . . . . . . . . . . . . . . . . . 20.5 10.8 12.4
1987 . . . . . . . . . . . . . . . . . . . . . . 20.3 10.6 12.5
1988 . . . . . . . . . . . . . . . . . . . . . . 19.5 10.5 12.0
1989 . . . . . . . . . . . . . . . . . . . . . . 19.6 10.2 11.4
1990 . . . . . . . . . . . . . . . . . . . . . . 20.6 10.7 12.2
1991 . . . . . . . . . . . . . . . . . . . . . . 21.8 11.4 12.4
1992 . . . . . . . . . . . . . . . . . . . . . . 22.3 11.9 12.9
1993 . . . . . . . . . . . . . . . . . . . . . . 22.7 12.4 12.2
1994 . . . . . . . . . . . . . . . . . . . . . . 21.8 11.9 11.7
1995 . . . . . . . . . . . . . . . . . . . . . . 20.8 11.4 10.5
1996 . . . . . . . . . . . . . . . . . . . . . . 20.6 11.4 10.8
1997 . . . . . . . . . . . . . . . . . . . . . . 19.9 10.9 10.5
1998 . . . . . . . . . . . . . . . . . . . . . . 18.9 10.5 10.5
1999 . . . . . . . . . . . . . . . . . . . . . . 17.1 10.1 9.7
2000 . . . . . . . . . . . . . . . . . . . . . . 16.2 9.6 9.9
2001 . . . . . . . . . . . . . . . . . . . . . . 16.3 10.1 10.1
2002 . . . . . . . . . . . . . . . . . . . . . . 16.7 10.6 10.4
2003 . . . . . . . . . . . . . . . . . . . . . . 17.6 10.8 10.2
2004 . . . . . . . . . . . . . . . . . . . . . . 17.8 11.3 9.8
2005 . . . . . . . . . . . . . . . . . . . . . . 17.6 11.1 10.1
2006 . . . . . . . . . . . . . . . . . . . . . . 17.4 10.8 9.4
2007 . . . . . . . . . . . . . . . . . . . . . . 18.0 10.9 9.7
2008 . . . . . . . . . . . . . . . . . . . . . . 19.0 11.7 9.7
2009 . . . . . . . . . . . . . . . . . . . . . . 20.7 12.9 8.9
2010 . . . . . . . . . . . . . . . . . . . . . . 22.0 13.8 8.9
2011 . . . . . . . . . . . . . . . . . . . . . . 21.9 13.7 8.7
2012 . . . . . . . . . . . . . . . . . . . . . . 21.8 13.7 9.1
2013 . . . . . . . . . . . . . . . . . . . . . . 21.5 13.3 10.2
2014 . . . . . . . . . . . . . . . . . . . . . . 21.1 13.5 10.0
2015 . . . . . . . . . . . . . . . . . . . . . . 19.7 12.4 8.8
NOTES: Civilian noninstitutionalized population. Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty
thresholds. See Appendix II, Poverty.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplements. Available from:
http://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-people.html. See Appendix I, Current Population Survey (CPS).
Percent of population
Metropolitan (urban) . . . . . . . . . . . . . . . . . . 73.2 72.2 79.7 82.6 85.6
Large central (inner cities) . . . . . . . . . . . . . 29.4 26.9 30.4 29.9 30.8
Large fringe (suburbs) . . . . . . . . . . . . . . . 12.3 12.9 19.4 23.4 24.8
Medium . . . . . . . . . . . . . . . . . . . . . . . 22.9 23.3 21.9 19.7 20.9
Small . . . . . . . . . . . . . . . . . . . . . . . . 8.6 9.1 8.0 9.5 9.1
Nonmetropolitan (rural) . . . . . . . . . . . . . . . . 26.8 27.8 20.3 17.4 14.4
Micropolitan (city/town). . . . . . . . . . . . . . . -- -- -- 10.5 8.5
Noncore (most rural) . . . . . . . . . . . . . . . . -- -- -- 6.9 5.9
NOTES: Resident population data are presented. The categories micropolitan and noncore were not used in 1970, 1980, and 1990; therefore, total nonmetropolitan
population is shown. The 2000 Office of Management and Budget metropolitan classification system included major changes, including the introduction of the
micropolitan category. Therefore, the nonmetropolitan categories for 1990 and earlier are not strictly analogous to subsequent data. The 1990 NCHS urban-rural
classification scheme for counties was applied to 1990 population data. The 2006 NCHS urban-rural classification scheme for counties was applied to 2000 population
data. The 2013 NCHS urban-rural classification scheme for counties was applied to 2015 population data. Available from:
http://www.cdc.gov/nchs/data_access/urban_rural.htm.
SOURCE: U.S. Census Bureau; 1970 and 1980 from Department of Agriculture Economic Research Service reports, available from:
http://naldc.nal.usda.gov/naldc/download.xhtml?id=CAT10847914&.
2015 1 . . . . . . . . . . 82.0 79.3 84.3 78.7 76.3 81.1 75.1 71.8 78.1
1
Life expectancy estimates for 2013 are based on final Medicare data. Life expectancy estimates for 2014 and 2015 are based on preliminary Medicare data.
2
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin. Life expectancies for the Hispanic population are adjusted for underreporting of
Hispanic ethnicity on the death certificate, but are not adjusted to account for the potential effects of return migration. To address the effects of age misstatement at
the oldest ages, the probability of death for Hispanic persons age 80 and over is estimated as a function of non-Hispanic white mortality with the use of the Brass
relational logit model. See Appendix II, Race, for a discussion of sources of bias in death rates by race and Hispanic origin.
NOTES: Populations for computing life expectancy for 19911999 are 1990-based postcensal estimates of the U.S. resident population. Populations for computing
life expectancy for 20012009 were based on intercensal population estimates of the U.S. resident population. Populations for computing life expectancy for 2010
were based on 2010 census counts. Life expectancy for 2011 and beyond was computed using 2010-based postcensal estimates. See Appendix I, Population Census
and Population Estimates. In 1997, life table methodology was revised to construct complete life tables by single years of age that extend to age 100. (Anderson RN.
Method for constructing complete annual U.S. life tables. NCHS. Vital Health Stat 2(129). 1999.) Previously, abridged life tables were constructed for 5-year age groups
ending with 85 years and over. In 2000, the life table methodology was revised. The revised methodology is similar to that developed for the 19992001 decennial
life tables. In 2008, the life table methodology was further refined. See Appendix II, Life expectancy. Starting with 2003 data, some states allowed the reporting of
more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of Management and
Budget standards, for comparability with other states. The race groups, white and black include persons of Hispanic and non-Hispanic origin. See Appendix II, Race.
Life expectancy is not currently available for persons of other racial and ethnic groups. Also see Table 15. Estimates for 2001 and onwards were revised based on the
methodology used in the 2008 life table report. Life expectancy for 20012012 was calculated using data from Medicare to supplement vital statistics and census data.
Starting with Health, United States, 2016, life expectancy estimates for 20102012, except as noted in Table 15, were revised to take into account updated race and
Hispanic origin classification ratios. See Arias E, Heron M, Hakes JK. The validity of race and Hispanic-origin reporting on death certificates in the United States: An
update. NCHS. Vital Health Stat 2(172). 2016. Available from: http://www.cdc.gov/nchs/data/series/sr_02/sr02_172.pdf.
SOURCE: NCHS, National Vital Statistics System, public-use Mortality Files; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington,
DC: U.S. Government Printing Office, 1968; Arias E. United States life tables by Hispanic origin. Vital health statistics; vol 2 no 152. Hyattsville, MD: NCHS. 2010;
United States Life Tables, 20012009 (using revised intercensal population estimates and a new methodology implemented with the final 2008 life tables);
United States Life Tables, 20102012 (using a new methodology implemented with the final 2008 life tables and updated race and Hispanic origin classification ratios);
United States Life Tables, 2013, forthcoming (using a new methodology implemented with the final 2008 life tables and updated race and Hispanic origin classification
ratios). Life table reports available from: http://www.cdc.gov/nchs/products/life_tables.htm; (for 2014 life expectancy) Xu J, Murphy SL, Kochanek KD, Arias E.
Mortality in the United States, 2015. NCHS data brief, no 267. Hyattsville, MD: NCHS; 2016. Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015.
National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm; unpublished 2015 life expectancy estimates
for white and black persons at birth. See Appendix I, National Vital Statistics System (NVSS).
1
Infant (under 1 year of age), neonatal (under 28 days), and postneonatal (28 days11 months).
2
Persons of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged
to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Hispanic origin; Race.
NOTES: Infant, neonatal, and postneonatal rates are based on the number of deaths from the mortality file and the number of births from the natality file. Infant mortality
rates by race and Hispanic origin are from the Linked Birth/Infant Death data set, in which the most recent data available is 2014.
SOURCE: NCHS, National Vital Statistics System (NVSS). See Appendix I, National Vital Statistics System (NVSS).
Age-adjusted death rates for the top 5 leading causes of death, 1975 and 2015
Cause of death 1
Chronic lower
Cerebrovascular Unintentional Influenza and respiratory
Heart disease Cancer diseases (Stroke) injuries pneumonia 2 diseases 3
Age-adjusted death rates for the top 5 leading causes of death, 1975 and 2015
Cause of death
Chronic lower
Cerebrovascular Unintentional Influenza and respiratory
Heart disease Cancer diseases (Stroke) injuries pneumonia 2 diseases 3
NOTES: For cause of death codes based on the ICD8 in 1975 and ICD10 in 2015, see Appendix II, Cause of death; Cause-of-death ranking; Table III; Table IV.
Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. The race groups, white, black, Asian or Pacific
Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. See Appendix II,
Race; Hispanic origin.
SOURCE: NCHS, National Vital Statistics System: Final Mortality Statistics, 1975. Monthly Vital Statistics Report, 25(Suppl. 11). 1977. Public-use 2015 Mortality File.
Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
Maternal age at first live-birth, by race and Hispanic origin of mother: 2015
Race and Hispanic origin of mother 2
Not Hispanic or Latina
Hispanic or Black or American Indian Asian or
Year Latina White African American or Alaska Native Pacific Islander
All ages . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0
Percent distribution
Less than 20 years . . . . . . . . . . . . . . . 21.2 9.1 19.5 27.3 2.4
2024 years . . . . . . . . . . . . . . . . . . . 35.6 25.1 39.4 39.7 12.2
2529 years . . . . . . . . . . . . . . . . . . . 22.7 31.0 21.8 20.0 33.0
3034 years . . . . . . . . . . . . . . . . . . . 13.7 24.6 12.6 8.9 36.0
3539 years . . . . . . . . . . . . . . . . . . . 5.5 8.5 5.3 3.3 13.3
40 years and over . . . . . . . . . . . . . . . . 1.3 1.8 1.4 0.9 3.2
Standard error
Less than 20 years . . . . . . . . . . . . . . . 0.07 0.03 0.09 0.41 0.04
2024 years . . . . . . . . . . . . . . . . . . . 0.09 0.05 0.11 0.45 0.10
2529 years . . . . . . . . . . . . . . . . . . . 0.08 0.05 0.09 0.37 0.14
3034 years . . . . . . . . . . . . . . . . . . . 0.06 0.05 0.07 0.26 0.14
3539 years . . . . . . . . . . . . . . . . . . . 0.04 0.03 0.05 0.16 0.10
40 years and over . . . . . . . . . . . . . . . . 0.02 0.01 0.03 0.09 0.05
1
Persons of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged
to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Hispanic origin; Race.
NOTES: Starting with 1970 data, births to persons who were not residents of the 50 states and the District of Columbia are excluded. Starting with
Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses. Rates for 2000 were
based on bridged-race April 1, 2000 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal population estimates
based on the 2000 and 2010 censuses. Rates for 2010 were based on bridged-race April 1, 2010 census counts. Rates for 2011 and beyond were computed using
2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Data for additional years are available. See the Excel spreadsheet
on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Race and Hispanic origin are reported separately on birth certificates. Race categories
are consistent with 1977 Office of Management and Budget standards. Forty-nine states and the District of Columbia reported multiple-race data for 2014 that were
bridged to single race categories for comparability with other states. Persons of Hispanic origin may be of any race. In this table, Hispanic women are classified only by
place of origin; non-Hispanic women are classified by race. See Technical Notes in Births: Final Data for 2015, available from:
http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf.
SOURCE: NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final data for 2015. National vital
statistics report; vol 66, no 1. Hyattsville, MD: NCHS. 2017; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. See Appendix I, National Vital
Statistics System (NVSS).
Sex and education level 1974 1 1979 1 1985 1 1990 1 1995 1 2000 2005 2010 2015
25 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
Both sexes 4 . . . . . . . . . . . . . . . . . . 36.9 33.1 30.0 25.4 24.5 22.6 20.3 19.2 15.6
No high school diploma or GED. . . . . . . . 43.7 40.7 40.8 36.7 35.6 31.6 28.2 26.9 25.6
High school diploma or GED . . . . . . . . . 36.2 33.6 32.0 29.1 29.1 29.2 27.0 27.0 22.9
Some college, no bachelor's degree . . . . . 35.9 33.2 29.5 23.4 22.6 21.7 21.8 21.3 17.9
Bachelor's degree or higher . . . . . . . . . . 27.2 22.6 18.5 13.9 13.6 10.9 9.1 8.3 5.9
Men 4 . . . . . . . . . . . . . . . . . . . . . . 42.9 37.3 32.8 28.2 26.4 24.7 22.7 21.0 17.1
No high school diploma or GED. . . . . . . . 52.3 47.6 45.7 42.0 39.7 36.0 31.7 29.7 28.6
High school diploma or GED . . . . . . . . . 42.4 38.9 35.5 33.1 32.7 32.1 29.9 29.3 24.3
Some college, no bachelor's degree . . . . . 41.8 36.5 32.9 25.9 23.7 23.3 24.9 23.2 18.7
Bachelor's degree or higher . . . . . . . . . . 28.3 22.7 19.6 14.5 13.8 11.6 9.7 8.7 6.6
Women 4 . . . . . . . . . . . . . . . . . . . . 32.0 29.5 27.5 22.9 22.9 20.5 18.0 17.5 14.3
No high school diploma or GED. . . . . . . . 36.6 34.8 36.5 31.8 31.7 27.1 24.6 23.7 22.6
High school diploma or GED . . . . . . . . . 32.2 29.8 29.5 26.1 26.4 26.6 24.1 24.9 21.2
Some college, no bachelor's degree . . . . . 30.1 30.0 26.3 21.0 21.6 20.4 19.1 19.6 17.2
Bachelor's degree or higher . . . . . . . . . . 25.9 22.5 17.1 13.3 13.3 10.1 8.5 7.9 5.3
Standard error
Both sexes 4 . . . . . . . . . . . . . . . . . . 0.3 0.4 0.3 0.3 0.4 0.3 0.3 0.3 0.3
No high school diploma or GED. . . . . . . . 0.6 0.8 0.8 0.7 1.1 0.8 0.8 0.9 1.0
High school diploma or GED . . . . . . . . . 0.6 0.6 0.6 0.4 0.7 0.6 0.6 0.7 0.7
Some college, no bachelor's degree . . . . . 1.0 0.9 0.8 0.6 0.8 0.5 0.5 0.6 0.5
Bachelor's degree or higher . . . . . . . . . . 0.8 0.8 0.7 0.5 0.7 0.4 0.4 0.4 0.3
Men 4 . . . . . . . . . . . . . . . . . . . . . . 0.5 0.5 0.5 0.4 0.6 0.5 0.5 0.5 0.5
No high school diploma or GED. . . . . . . . 0.9 1.1 1.2 1.1 1.7 1.2 1.2 1.3 1.5
High school diploma or GED . . . . . . . . . 1.0 0.9 0.9 0.7 1.1 0.9 0.9 1.1 1.0
Some college, no bachelor's degree . . . . . 1.7 1.5 1.2 0.9 1.3 0.8 0.9 0.9 0.8
Bachelor's degree or higher . . . . . . . . . . 1.2 1.0 0.9 0.7 0.9 0.6 0.5 0.5 0.5
Women 4 . . . . . . . . . . . . . . . . . . . . 0.4 0.5 0.4 0.3 0.6 0.4 0.4 0.4 0.4
No high school diploma or GED. . . . . . . . 0.8 0.9 1.0 0.9 1.4 1.0 1.1 1.3 1.2
High school diploma or GED . . . . . . . . . 0.8 0.7 0.7 0.5 0.9 0.8 0.8 0.9 1.0
Some college, no bachelor's degree . . . . . 1.4 1.1 0.9 0.7 1.1 0.7 0.7 0.8 0.7
Bachelor's degree or higher . . . . . . . . . . 1.4 1.1 1.0 0.7 0.9 0.5 0.5 0.5 0.4
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 2534 years, 3544 years, 4564 years, and 65 years and over. See Appendix
II, Age adjustment. For age groups where smoking was 0% or 100%, the age-adjustment procedure was modified to substitute the percentage smoking from the next
lower education group.
3
Starting with 1993 data (shown in spreadsheet version of Table 48), current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and
smoking now every day or some days. For previous definition, see Appendix II, Cigarette smoking.
4
Includes unknown education level. Education categories shown are for 1997 (shown in spreadsheet version of Table 48) and subsequent years. GED is General
Educational Development high school equivalency diploma. In 19741995, the following categories based on number of years of school completed were used: less
than 12 years, 12 years, 1315 years, 16 years or more. See Appendix II, Education.
NOTES: Estimates are age-adjusted. The data table only presents selected years of data for Figure 10. For additional data years, see the Excel spreadsheet version of
Table 48 on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: hypertension (1974), smoking (1979), alcohol and health
practices (1983), health promotion and disease prevention (1985, 19901991), cancer control and cancer epidemiology (1992), and year 2000 objectives (19931995).
Starting with 1997, data are from the family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
219 years with obesity 1 . . . . . . 10.0 0.5 13.9 0.9 15.4 0.9 17.1 1.3 15.5 1.3 16.8 1.3 16.9 0.7 16.9 1.0 17.2 1.1
20 years and over, age-adjusted 2,3:
Obesity (all grades) . . . . . . . . 22.9 0.7 30.5 1.5 30.5 1.2 32.3 1.2 34.4 1.4 33.7 1.1 35.7 0.9 34.9 1.3 37.8 0.9
Grade 1 obesity . . . . . . . . 14.8 0.4 17.3 0.8 18.4 0.8 20.0 0.7 19.6 0.7 19.5 0.6 20.3 0.7 20.5 0.9 20.7 0.7
Grade 2 obesity . . . . . . . . 5.2 0.4 8.5 0.6 6.9 0.6 7.4 0.5 8.9 0.7 8.6 0.5 9.1 0.5 8.1 0.5 9.5 0.4
Grade 3 obesity . . . . . . . . 2.9 0.2 4.7 0.6 5.1 0.5 4.8 0.6 5.9 0.5 5.6 0.4 6.3 0.3 6.3 0.5 7.6 0.7
20 years and over, crude 2:
Obesity (all grades) . . . . . . . . 22.3 0.7 30.3 1.5 30.6 1.1 32.3 1.2 34.7 1.4 33.9 1.1 35.9 0.9 35.1 1.4 37.9 0.8
Grade 1 obesity . . . . . . . . 14.4 0.4 17.2 0.8 18.5 0.8 20.0 0.8 19.7 0.7 19.6 0.6 20.5 0.7 20.6 0.9 20.8 0.7
Grade 2 obesity . . . . . . . . 5.1 0.4 8.4 0.5 7.0 0.6 7.4 0.5 9.0 0.7 8.6 0.5 9.1 0.5 8.2 0.5 9.5 0.4
Grade 3 obesity . . . . . . . . 2.8 0.2 4.7 0.6 5.2 0.5 4.9 0.6 6.0 0.5 5.7 0.4 6.3 0.2 6.4 0.6 7.7 0.7
SE is standard error.
1
Obesity among children aged 219 is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile from the 2000 CDC Growth Charts:
United States. Kuczmarski RJ, Ogden CL, Guo SS, GrummerStrawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC Growth Charts for
the United States: methods and development. Vital Health Stat 11. 2002 May;(246):1190. Available at: http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf. In
Health, United States, the NHANES variable, Body Mass Index, is used to assign persons to BMI categories.
2
Obesity among adults is defined as body mass index (BMI) greater than or equal to 30.0. Grade 1 obesity is defined as BMI from 30.0 to 34.9; Grade 2 obesity is
defined as BMI from 35.0 to 39.9; and Grade 3 obesity is defined as BMI greater than or equal to 40.0. In Health, United States, the NHANES variable, Body Mass
Index, is used to assign persons to BMI categories. See Appendix II, Body mass index (BMI).
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 2034 years, 3544 years, 4554 years, 5564 years, and 65 years and over.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
SE is standard error.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%.
1
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services poverty guideline specific to family size, as
well as the appropriate year, and state. See Appendix II, Family income; Poverty.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 2034 years, 3549 years, 5064 years, 6574 years, and 75 years and over.
NOTES: Also see Table 60. Untreated dental caries refers to decay on the crown or enamel surface of a tooth (i.e., coronal caries) that has not been treated or filled.
Decay in the root (i.e., root caries) was not included. The presence of caries was evaluated in primary and permanent teeth for persons aged 5 and older. The third
molars were not included. Persons without at least one natural tooth (primary or permanent) were classified as edentulous (without any teeth) and were excluded.
The majority of edentulous persons are aged 65 and over. Age-adjusted estimates of edentulism among persons aged 65 and over are 34% in 19881994, 27% in
19992004, and 18% in 20112014.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Percent of population
All persons. . . . . . . . . . . . . . . 8.8 0.5 11.9 0.6 5.2 0.4 9.0 0.6 3.6 0.3 2.9 0.3
Not Hispanic or Latino:
White only. . . . . . . . . . . . . . 7.7 0.6 9.6 0.7 4.8 0.5 7.6 0.7 2.9 0.3 2.0 0.3
Black or African American only . . . 16.3 0.9 18.0 1.3 9.1 0.7 13.4 0.8 7.2 0.5 4.6 0.8
Asian only . . . . . . . . . . . . . . --- --- 16.3 1.4 --- --- 10.4 1.0 --- --- 5.9 1.1
Hispanic or Latino:
Mexican origin . . . . . . . . . . . 15.6 0.9 18.0 1.7 10.7 0.9 13.0 1.0 5.0 0.7 5.1 1.0
SE is standard error.
NOTES: All persons includes persons of all other races and Hispanic origins not shown separately. For more information, see Appendix II, Diabetes. Estimates are
age-adjusted to the year 2000 standard population using three age groups: 2044 years, 4564 years, and 65 years and over. See Table 40.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Uncontrolled high blood pressure among adults aged 20 and over with hypertension 1
19881994 19992002 20032006 20072010 20112014
Sex and age Percent SE Percent SE Percent SE Percent SE Percent SE
Percent of population
20112014
Sex and age Percent SE
Men:
2034 years . . . . . . . . . . . . . . . . . 74.1 4.6
3544 years . . . . . . . . . . . . . . . . . 64.2 5.1
4564 years . . . . . . . . . . . . . . . . . 49.7 3.1
6574 years . . . . . . . . . . . . . . . . . 38.2 3.1
75 years and over. . . . . . . . . . . . . . 46.5 4.4
Women:
2034 years . . . . . . . . . . . . . . . . . 55.5 8.0
3544 years . . . . . . . . . . . . . . . . . 37.7 3.7
4564 years . . . . . . . . . . . . . . . . . 36.8 2.7
6574 years . . . . . . . . . . . . . . . . . 44.5 2.8
75 years and over. . . . . . . . . . . . . . 61.5 3.0
SE is standard error.
1
Uncontrolled high blood pressure among adults with hypertension is defined as measured systolic pressure of at least 140 mm Hg or diastolic pressure of at least
90 mm Hg, among those with measured high blood pressure or reporting taking antihypertensive medication.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 2034 years, 3544 years, 4554 years, 5564 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment; Blood pressure, high. Also see Table 54.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Percent
1844 years . . . . . . . . . . 31.3 34.7 37.0 38.3 36.6 39.0 38.4 37.7 36.5
4564 years . . . . . . . . . . 54.8 62.1 65.3 67.1 63.3 66.3 66.0 68.4 69.6
65 years and over . . . . . . . 73.6 83.9 85.7 88.8 90.0 90.3 89.1 90.4 90.8
Standard error
1844 years . . . . . . . . . . 0.8 1.4 2.3 1.3 1.1 1.2 2.0 1.6 1.3
4564 years . . . . . . . . . . 1.0 2.1 2.3 1.4 1.0 2.0 1.5 1.2 1.4
65 years and over . . . . . . . 0.9 1.2 1.3 1.2 0.9 0.9 0.8 1.3 1.1
Prescription drug use in the past 30 days, by age and number of drugs taken
Age and number of drugs taken 19881994 20132014
SE is standard error.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
SE is standard error.
1
Generalist includes providers practicing general practice, family medicine, and internal medicine. Specialist includes providers specializing in a particular disease
or problem. Eye doctor includes optometrists and ophthalmologists. Mental health providers include psychiatrists, psychologists, psychiatric nurses, clinical social
workers, and other mental health professionals. Dentist includes orthodontists, oral surgeons, dental hygienists, and other dental specialists.
NOTES: Respondents were asked a series of questions about the different types of health care contacts they have had in the past 12 months: "During the past 12
months, have you seen or talked to any of the following health care providers about your own/your child's health?".
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
1
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage.
2
Children's Health Insurance Plan (CHIP) and state-sponsored health plan coverage are included as Medicaid coverage.
3
Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans, Medicare, or military plans are considered to
have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Age
Gender and year 117 years 1844 years 4564 years 6574 years 75 years and over
Age
Gender and year 117 years 1844 years 4564 years 6574 years 75 years and over
Age
Gender and year 117 years 1844 years 4564 years 6574 years 75 years and over
Age
Gender and year 117 years 1844 years 4564 years 6574 years 75 years and over
NOTES: Estimates for hospital stays include those relating to deliveries but exclude stays for institutionalized persons as well as stays that ended in death.
Consequently, the estimates shown will vary from those based on a survey of hospital discharges. The difference will be larger for older persons, since they have greater
likelihood of being institutionalized and higher death rates than younger persons. See Appendix II, Hospital utilization; Table 81.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Use of any colorectal test or procedure among adults aged 5075: United States, selected years 20002015
* Estimates are considered unreliable. Data not shown have an RSE greater than 30%.
1
Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. Prior to 1999, data were tabulated according to the 1977 Standards with four racial groups,
and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Questions concerning use of mammography differed slightly on the National Health Interview Survey across the survey years. See Appendix II, Mammography. Data
prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign.
3
Adults with a colorectal test or procedure are those who reported a home fecal occult blood test (FOBT) in the past year, a sigmoidoscopy procedure in the past
five years with FOBT in the past three years, or a colonoscopy in the past 10 years. Questions concerning colorectal testing differed slightly on the National Health
Interview Survey across survey years. See Appendix II, Colorectal tests or procedures.
4
Colorectal cancer testing data begin in 2000 due to changes in available procedures prior to 2000.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
NOTES: Average length of stay is the number of inpatient days divided by the number of admissions. Occupancy rate is the average daily census divided by the
number of hospital beds, cribs, and pediatric bassinets set up and staffed on the last day of the reporting period, expressed as a percentage. For 1975, 1985, and
1995 data, civilian population is used for beds per 1,000 population and resident population is used for 2005 and 2014 data. See Appendix II, Average length of stay;
SOURCE: American Hospital Association (AHA). Annual Survey of Hospitals. Hospital Statistics, 1976, 1986, 1998, 2007, and 2016 editions. Chicago, IL. [Reprinted
from AHA Hospital Statistics by permission, Copyright 1976, 1986, 1998, 2007, and 2016 by Health Forum, LLC, an American Hospital Association Company.] See
Characteristic 1975 1980 1985 1990 1995 2000 2005 2010 2013
NOTES: Rates per 10,000 civilian population for 1975 to 2010. For 2013, rates per 10,000 resident population. Primary care generalist physicians include family
medicine, internal medicine, obstetrics and gynecology, and pediatrics. Specialists include all other specialties and primary care subspecialists. Excludes physicians
who are inactive or who did not provide generalist/specialist information. See Appendix II, Physician specialty.
SOURCE: American Medical Association (AMA): Physician distribution and medical licensure in the U.S., 1975; Physician characteristics and distribution in the U.S.,
1981, 1986, 1992, 1997, 20022003, 2007, 2012, 2015 editions; Department of Physician Practice and Communications Information, Division of Survey and Data
Resources, AMA. [Copyright 1976, 1982, 1986, 1992, 1997, 2003, 2007, 2012, and 2015: Used with permission of the AMA.] See Appendix I, American Medical
NOTES: Rates are for resident population. Occupancy rate is the percentage of beds occupied (number of nursing home residents per 100 nursing home beds). See
Appendix II, Occupancy rate.
SOURCE: NCHS, the National Nursing Home Survey (NNHS) for 1977, 1985, 1995, and 2004 data, available from:
http://www.cdc.gov/nchs/data/nnhsd/nursinghomes1973-2004.pdf; https://www.cdc.gov/nchs/data/series/sr_13/sr13_102.pdf;
http://www.cdc.gov/nchs/data/ad/ad280.pdf; https://www.cdc.gov/nchs/data/ad/ad289.pdf; http://www.cdc.gov/nchs/data/series/sr_13/sr13_167.pdf; the National
Study of Long-Term Care Providers for 2014, available from: http://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf. See Appendix I, National Study of Long-Term
Care Providers (NSLTCP) and National Nursing Home Survey (NNHS).
Amount, in billions
Personal health care expenditures 1 . . . . . . . . . . . . . . $113 $870 $2,717
Source of funds: Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0
Private health insurance . . . . . . . . . . . . . . . . . . . 24.5 33.0 34.8
Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.8 20.7 22.3
Medicaid, total 2 . . . . . . . . . . . . . . . . . . . . . . . 11.3 15.7 18.3
Medicaid (federal). . . . . . . . . . . . . . . . . . . . . . 6.2 9.4 11.6
Medicaid (state) . . . . . . . . . . . . . . . . . . . . . . . 5.1 6.3 6.7
Out of pocket . . . . . . . . . . . . . . . . . . . . . . . . 32.9 16.7 12.4
All other sources of funds 3 . . . . . . . . . . . . . . . . . . 17.5 14.0 12.2
Type of expenditure:
All types of expenditures . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0
Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.3 39.0 38.1
Physician and clinical . . . . . . . . . . . . . . . . . . . . 22.4 25.3 23.4
Prescription drugs . . . . . . . . . . . . . . . . . . . . . . 7.1 6.9 11.9
Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 5.1 4.3
Nursing care facilities and continuing care
retirement communities. . . . . . . . . . . . . . . . . . . 7.1 7.4 5.8
Home health care . . . . . . . . . . . . . . . . . . . . . . 0.5 3.7 3.3
All other types of expenditures 4 . . . . . . . . . . . . . . . 10.6 12.5 13.2
1
Personal health care expenditures are in current dollars and are not adjusted for inflation.
2
Medicaid includes expenditures for the Children's Health Insurance Program (CHIP).
3
Other sources include Department of Defense, Department of Veterans Affairs, and other third party payers and programs.
4
Other types of expenditures include other professional services; other health, residential, and personal care; and durable and nondurable medical equipment
and products.
NOTES: Personal health care expenditures are outlays for goods and services relating directly to patient care. See Appendix II, Health expenditures, national; Table 95.
SOURCE: Centers for Medicare & Medicaid Services, National Health Expenditure Accounts. See Appendix I, National Health Expenditure Accounts (NHEA).
1
Inpatient expenditures are spending for care provided in an acute medical care unit or setting of a general hospital or in specialty mental health or substance use
disorder hospitals.
2
Outpatient expenditures are spending for care provided in settings such as hospital outpatient departments, emergency departments, or offices and clinics of
physicians and other medical professionals. This category includes partial hospitalization and intensive outpatient services offered by hospital outpatient departments
as well as case management and intensive outpatient services offered by health clinics and specialty mental health and substance use disorder centers. Care provided
by home health providers was counted as outpatient service.
3
Residential expenditures are spending for therapeutic care provided by licensed health professionals in a 24-hour care setting, including residential care in specialty
mental health and substance use disorder centers and all nursing home care. Starting in 2009, this category was broadened to encompass residential treatment
facilities that included residential substance use disorder and mental health facilities. Trends for residential treatment expenditures should be interpreted with caution.
4
Retail prescription drug expenditures are spending for psychotherapeutic and substance use disorder medications sold in retail establishments such as community
pharmacies, mass merchandise retailers, grocery stores, or through mail order pharmacies. Excluded were sales through hospital pharmacies (which were counted
with hospital expenditures), exclusive-to-patient HMOs, and nursing home pharmacies (which were counted where the pharmacy was located). Methadone is
not included in retail prescription drug expenditures for substance abuse treatment. Instead, it is captured in the estimates of specialty substance use disorder
treatment centers.
5
Insurance administration covers the cost of running various government health care programs, the net cost of private health insurance, and the administrative costs
associated with operating philanthropic organizations that provide donations for health care.
NOTES: Mental health and substance use disorder expenditures focus on spending for treatment as opposed to disease burden. These expenditures exclude comorbid
health costs and other costs of patient care such as job training, subsidized housing, lost wages, and lost productivity. Mental health and substance use disorder
spending was based on the following principal or primary diagnosis codes from the International Classification of Diseases, 9th Revision, Clinical Modification
(ICD9CM): 291292, 295304, 305.2305.9, 306314, 648.3, 648.4.
SOURCE: Substance Abuse and Mental Health Services Administration (SAMHSA), Behavioral Health and Spending Use Accounts. Substance Abuse and Mental
Health Services Administration. Behavioral health spending and use accounts, 19862014. HHS Publication no. SMA-16-4975. Rockville, MD: SAMHSA; 2016.
Available from: http://store.samhsa.gov/shin/content/SMA16-4975/SMA16-4975.pdf. See Appendix I, Behavioral Health Spending and Use Accounts (BHSUA).
1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5
1996 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8
1997 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.5
1998 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
1999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2
2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.8
2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.8
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9
2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1
2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.0
2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.9
2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.5
2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.9
2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.7
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.3
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.0
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.4
2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.0
2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.9
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.3
NOTES: Prior to 2004, enrollment and percentage of enrollees in managed care were based on a 5% annual Denominator File derived from the Centers for Medicare &
Medicaid Services' (CMS) Enrollment Database. Starting with 2004 data, the enrollee counts were pulled from the 100% Denominator File. See Appendix II, Managed
care; Table 112. State is based on residence of the beneficiary.
SOURCE: Centers for Medicare & Medicaid Services; Office of Research, Development, and Information. Health Care Financing Review: Medicare and Medicaid
Statistical Supplements for publication years 1996 to 2010; Center for Strategic Planning. Medicare & Medicaid Research Review: Medicare and Medicaid Statistical
Supplement for publication year 2011; Office of Information Products and Data Analytics. Medicare and Medicaid Statistical Supplements for publication year 2012.
Data for 20132015 are unpublished. See Appendix I, Medicare Administrative Data.
Percent
1978 . . . . . . . . . . . . . . . 75.1 67.6 11.3 12.0
1980 . . . . . . . . . . . . . . . 75.7 69.1 11.8 11.6
1982 . . . . . . . . . . . . . . . 74.0 67.8 10.4 14.0
1983 . . . . . . . . . . . . . . . 72.5 66.0 11.6 14.2
1984 . . . . . . . . . . . . . . . 72.6 66.5 11.9 13.9
1986 . . . . . . . . . . . . . . . 72.7 66.6 11.2 14.5
1989 . . . . . . . . . . . . . . . 71.8 65.8 12.6 14.7
1990 . . . . . . . . . . . . . . . 68.9 60.9 12.7 17.1
1991 . . . . . . . . . . . . . . . 68.1 55.2 15.3 15.4
1992 . . . . . . . . . . . . . . . 66.7 60.9 18.1 14.2
1993 . . . . . . . . . . . . . . . 66.1 61.7 20.2 14.2
1994 . . . . . . . . . . . . . . . 63.2 58.5 21.2 15.0
1995 . . . . . . . . . . . . . . . 65.2 60.4 21.5 13.4
1996 . . . . . . . . . . . . . . . 66.4 61.1 20.7 13.3
1997 . . . . . . . . . . . . . . . 66.1 62.8 18.4 14.0
1998 . . . . . . . . . . . . . . . 68.4 64.3 17.1 12.7
1999 . . . . . . . . . . . . . . . 68.8 65.0 18.1 11.9
2000 4 . . . . . . . . . . . . . . . 66.6 63.0 19.6 12.6
2001 4 . . . . . . . . . . . . . . . 66.3 63.0 21.5 11.2
2002 4 . . . . . . . . . . . . . . . 63.5 60.4 24.8 10.9
2003 . . . . . . . . . . . . . . . 63.0 59.4 26.0 9.8
2004 . . . . . . . . . . . . . . . 63.2 59.6 26.4 9.2
2005 . . . . . . . . . . . . . . . 62.1 58.6 27.2 9.3
2006 . . . . . . . . . . . . . . . 59.4 55.5 29.9 9.5
2007 . . . . . . . . . . . . . . . 59.8 55.8 29.8 9.0
2008 . . . . . . . . . . . . . . . 58.4 54.4 31.3 9.0
2009 . . . . . . . . . . . . . . . 55.8 51.8 34.5 8.2
2010 . . . . . . . . . . . . . . . 54.1 50.7 36.4 7.8
2011 . . . . . . . . . . . . . . . 53.7 49.7 38.2 7.0
2012 . . . . . . . . . . . . . . . 53.4 49.9 38.9 6.6
2013 . . . . . . . . . . . . . . . 53.2 49.3 38.9 6.6
2014 . . . . . . . . . . . . . . . 53.7 49.3 39.4 5.4
2015 . . . . . . . . . . . . . . . 54.6 49.6 39.9 4.5
2016, JanSep 5 . . . . . . . . . 53.5 49.2 39.2 5.0
See footnotes at end of table.
Standard error
1978 . . . . . . . . . . . . . . . 1.0 1.0 0.7 0.6
1980 . . . . . . . . . . . . . . . 0.9 0.9 0.7 0.6
1982 . . . . . . . . . . . . . . . 0.9 0.9 0.7 0.6
1983 . . . . . . . . . . . . . . . 1.0 1.1 0.7 0.7
1984 . . . . . . . . . . . . . . . 0.9 0.9 0.6 0.5
1986 . . . . . . . . . . . . . . . 0.9 0.9 0.5 0.6
1989 . . . . . . . . . . . . . . . 0.6 0.6 0.4 0.5
1990 . . . . . . . . . . . . . . . 0.6 0.6 0.4 0.4
1991 . . . . . . . . . . . . . . . 0.6 0.7 0.4 0.4
1992 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
1993 . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.4
1994 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.4
1995 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
1996 . . . . . . . . . . . . . . . 0.7 0.8 0.6 0.4
1997 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
1998 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
1999 . . . . . . . . . . . . . . . 0.5 0.5 0.4 0.3
2000 4 . . . . . . . . . . . . . . . 0.5 0.5 0.5 0.3
2001 4 . . . . . . . . . . . . . . . 0.6 0.5 0.5 0.4
2002 4 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
2003 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
2004 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
2005 . . . . . . . . . . . . . . . 0.6 0.6 0.5 0.3
2006 . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.3
2007 . . . . . . . . . . . . . . . 0.7 0.7 0.6 0.4
2008 . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.4
2009 . . . . . . . . . . . . . . . 0.8 0.8 0.7 0.4
2010 . . . . . . . . . . . . . . . 0.7 0.7 0.6 0.3
2011 . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.3
2012 . . . . . . . . . . . . . . . 0.6 0.6 0.6 0.3
2013 . . . . . . . . . . . . . . . 0.7 0.7 0.6 0.3
2014 . . . . . . . . . . . . . . . 0.6 0.6 0.6 0.2
2015 . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.2
2016, JanSep 5 . . . . . . . . . 0.9 0.9 0.8 0.4
1
Respondents were considered to be covered by private coverage if they indicated private coverage or, prior to 1997, if they were covered by a single-service hospital
plan. This category excludes plans that paid for only one type of specialized service, such as accidents or dental care. Private health insurance includes managed care
such as health maintenance organizations (HMOs). Private workplace coverage includes private coverage originally obtained through a present or former employer
or union or starting in 1997, through the workplace, self-employment, or a professional association. Starting in 2014, an additional question on the health insurance
marketplace was added to the questionnaire for those respondents who did not indicate that their health plan was obtained through a present or former employer,
union, self-employment, or professional association. Starting in 2015, an additional answer category was added to the question on how a health plan was originally
obtained to allow a respondent to indicate that their plan was obtained through the Health Insurance Marketplace or state-based exchange.
2
Until 1996, persons were defined as having Medicaid or other public assistance coverage if they indicated that they had either Medicaid or other public assistance
or if they reported receiving Aid to Families with Dependent Children (AFDC) or Supplemental Security Income (SSI). After welfare reform in late 1996, Medicaid was
delinked from AFDC and SSI. Starting in 1997, persons were considered to be covered by Medicaid if they reported Medicaid or a state-sponsored health program.
Starting in 1999, persons were considered covered by Medicaid if they reported coverage by the Children's Health Insurance Program (CHIP), which was originally
enacted in 1997. CHIP funding is currently extended through 2017. See Appendix II, Children's Health Insurance Program (CHIP). Beginning in quarter 3 of the 2004
NHIS, persons under age 65 with no reported coverage were asked explicitly about Medicaid coverage. Estimates for 2004 and subsequent years were calculated
with the additional information from this question. Estimates are presented for 1978 and onwards because that was the first year direct questions were included on
Medicaid and Medicare coverage (for persons under age 65 years).
3
Persons not covered by private insurance, Medicaid, Children's Health Insurance Program (CHIP), public assistance (through 1996), state-sponsored or other
government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian
Health Service coverage are considered to have no health insurance coverage.
4
Estimates for 2000-2002 were calculated using 2000-based sample weights and may differ from estimates in other reports that used 1990-based sample weights for
2000-2002 estimates.
5
Preliminary data based on the National Health Interview Survey's Early Release program. Estimates based on the preliminary 9-month file may differ from estimates
based on the final annual file and have larger standard errors associated with them than standard errors based on a final annual file. Available from: Martinez ME,
Zammitti EP, Cohen RA. Health insurance coverage: Early release of estimates from the National Health Interview Survey, JanuarySeptember 2016. NCHS. February
2017. Available from: https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201702.pdf; and National Health Interview Survey, 2016 preliminary file. For more
information, visit: http://www.cdc.gov/nchs/nhis/htm.
NOTES: Health insurance coverage, definitions, and questionnaires have changed over time. Health insurance status is at the time of interview except for 19901996,
when it is for the month prior to interview. Persons classified with Private or Medicaid coverage may also have other types of coverage. Respondents who did not report
coverage under a type of plan and had unknown coverage under private or Medicaid were considered to have unknown coverage. Persons had to be known on health
insurance coverage to be classified as having private coverage, Medicaid, or being uninsured. See Appendix II, Health insurance coverage; Tables 102105. For more
information on historic health insurance trends, see: Cohen RA, Makuc DM, Bernstein AB, Bilheimer LT, Powell-Griner E. Health insurance coverage trends, 19592007:
Estimates from the National Health Interview Survey. National health statistics reports; no 17. Hyattsville, MD: NCHS. 2009. Available from:
http://www.cdc.gov/nchs/data/nhsr/nhsr017.pdf.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Percent
1978 . . . . . . . . . . . . . . . 81.4 71.4 4.4 11.9
1980 . . . . . . . . . . . . . . . 81.2 72.4 4.9 12.2
1982 . . . . . . . . . . . . . . . 79.9 71.4 4.1 13.8
1983 . . . . . . . . . . . . . . . 78.8 69.5 4.7 14.7
1984 . . . . . . . . . . . . . . . 78.6 70.3 4.5 14.8
1986 . . . . . . . . . . . . . . . 78.6 70.4 4.3 15.2
1989 . . . . . . . . . . . . . . . 77.6 69.4 4.9 16.0
1990 . . . . . . . . . . . . . . . 76.5 68.8 4.7 17.2
1991 . . . . . . . . . . . . . . . 76.0 66.0 5.6 16.8
1992 . . . . . . . . . . . . . . . 74.3 66.6 6.2 17.7
1993 . . . . . . . . . . . . . . . 73.2 66.8 6.5 18.8
1994 . . . . . . . . . . . . . . . 72.9 66.2 6.8 18.6
1995 . . . . . . . . . . . . . . . 73.9 67.6 7.1 17.3
1996 . . . . . . . . . . . . . . . 73.3 66.9 6.8 18.3
1997 . . . . . . . . . . . . . . . 72.7 68.0 5.9 19.0
1998 . . . . . . . . . . . . . . . 73.8 68.9 5.3 18.3
1999 . . . . . . . . . . . . . . . 74.6 69.8 5.3 17.9
2000 4 . . . . . . . . . . . . . . . 73.5 68.8 5.2 18.9
2001 4 . . . . . . . . . . . . . . . 73.3 68.6 5.7 18.5
2002 4 . . . . . . . . . . . . . . . 71.9 67.4 6.5 19.3
2003 . . . . . . . . . . . . . . . 71.4 66.5 6.6 19.3
2004 . . . . . . . . . . . . . . . 71.1 65.8 6.8 19.3
2005 . . . . . . . . . . . . . . . 70.7 65.7 7.2 19.3
2006 . . . . . . . . . . . . . . . 69.1 63.9 7.7 20.0
2007 . . . . . . . . . . . . . . . 69.5 63.9 7.5 19.6
2008 . . . . . . . . . . . . . . . 68.5 62.9 8.1 19.9
2009 . . . . . . . . . . . . . . . 66.2 60.4 8.9 21.2
2010 . . . . . . . . . . . . . . . 64.7 58.9 9.2 22.3
2011 . . . . . . . . . . . . . . . 65.0 59.1 9.9 21.2
2012 . . . . . . . . . . . . . . . 65.1 59.6 10.0 20.9
2013 . . . . . . . . . . . . . . . 65.1 59.5 10.2 20.5
2014 . . . . . . . . . . . . . . . 67.4 59.2 12.1 16.3
2015 . . . . . . . . . . . . . . . 69.7 60.4 13.2 13.0
2016, JanSep 5 . . . . . . . . . 69.0 60.9 14.1 12.3
See footnotes at end of table.
Standard error
1978 . . . . . . . . . . . . . . . 0.6 0.7 0.3 0.4
1980 . . . . . . . . . . . . . . . 0.6 0.7 0.3 0.4
1982 . . . . . . . . . . . . . . . 0.6 0.6 0.3 0.4
1983 . . . . . . . . . . . . . . . 0.7 0.7 0.3 0.5
1984 . . . . . . . . . . . . . . . 0.5 0.5 0.2 0.4
1986 . . . . . . . . . . . . . . . 0.5 0.6 0.2 0.4
1989 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.2
1990 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.2
1991 . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.2
1992 . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.3
1993 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
1994 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
1995 . . . . . . . . . . . . . . . 0.3 0.4 0.2 0.2
1996 . . . . . . . . . . . . . . . 0.4 0.5 0.2 0.3
1997 . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.2
1998 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.3
1999 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.3
2000 4 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.3
2001 4 . . . . . . . . . . . . . . . 0.3 0.3 0.1 0.3
2002 4 . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.3
2003 . . . . . . . . . . . . . . . 0.3 0.4 0.2 0.3
2004 . . . . . . . . . . . . . . . 0.3 0.4 0.2 0.3
2005 . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.3
2006 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2007 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2008 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2009 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2010 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2011 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2012 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2013 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2014 . . . . . . . . . . . . . . . 0.4 0.4 0.2 0.3
2015 . . . . . . . . . . . . . . . 0.4 0.4 0.3 0.2
2016, JanSep 5 . . . . . . . . . 0.5 0.5 0.4 0.4
1
Respondents were considered to be covered by private coverage if they indicated private coverage or, prior to 1997, if they were covered by a single-service hospital
plan. This category excludes plans that paid for only one type of specialized service, such as accidents or dental care. Private health insurance includes managed care
such as health maintenance organizations (HMOs). Private workplace coverage includes private coverage originally obtained through a present or former employer
or union or starting in 1997, through the workplace, self-employment, or a professional association. Starting in 2014, an additional question on the health insurance
marketplace was added to the questionnaire for those respondents who did not indicate that their health plan was obtained through a present or former employer,
union, self-employment, or professional association. Starting in 2015, an additional answer category was added to the question on how a health plan was originally
obtained to allow a respondent to indicate that their plan was obtained through the Health Insurance Marketplace or state-based exchange.
2
Until 1996, persons were defined as having Medicaid or other public assistance coverage if they indicated that they had either Medicaid or other public assistance
or if they reported receiving Aid to Families with Dependent Children (AFDC) or Supplemental Security Income (SSI). After welfare reform in late 1996, Medicaid was
delinked from AFDC and SSI. Starting in 1997, persons were considered to be covered by Medicaid if they reported Medicaid or a state-sponsored health program.
Starting in 1999, persons were considered covered by Medicaid if they reported coverage by the Children's Health Insurance Program (CHIP), which was originally
enacted in 1997. CHIP funding is currently extended through 2017. See Appendix II, Children's Health Insurance Program (CHIP). Beginning in quarter 3 of the 2004
NHIS, persons under age 65 with no reported coverage were asked explicitly about Medicaid coverage. Estimates for 2004 and subsequent years were calculated
with the additional information from this question. Estimates are presented for 1978 and onwards because that was the first year direct questions were included on
Medicaid and Medicare coverage (for persons under age 65 years).
3
Persons not covered by private insurance, Medicaid, Children's Health Insurance Program (CHIP), public assistance (through 1996), state-sponsored or other
government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian
Health Service coverage are considered to have no health insurance coverage.
4
Estimates for 2000-2002 were calculated using 2000-based sample weights and may differ from estimates in other reports that used 1990-based sample weights for
2000-2002 estimates.
5
Preliminary data based on the National Health Interview Survey's Early Release program. Estimates based on the preliminary 9-month file may differ from estimates
based on the final annual file and have larger standard errors associated with them than standard errors based on a final annual file. Available from: Martinez ME,
Zammitti EP, Cohen RA. Health insurance coverage: Early release of estimates from the National Health Interview Survey, JanuarySeptember 2016. NCHS. February
2017. Available from: https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201702.pdf; and National Health Interview Survey, 2016 preliminary file. For more
information, visit: http://www.cdc.gov/nchs/nhis/htm.
NOTES: Health insurance coverage, definitions, and questionnaires have changed over time. Health insurance status is at the time of interview except for 19901996,
when it is for the month prior to interview. Persons classified with Private or Medicaid coverage may also have other types of coverage. Respondents who did not report
coverage under a type of plan and had unknown coverage under private or Medicaid were considered to have unknown coverage. Persons had to be known on health
insurance coverage to be classified as having private coverage, Medicaid, or being uninsured. See Appendix II, Health insurance coverage; Tables 102105. For more
information on historic health insurance trends, see: Cohen RA, Makuc DM, Bernstein AB, Bilheimer LT, Powell-Griner E. Health insurance coverage trends, 19592007:
Estimates from the National Health Interview Survey. National health statistics reports; no 17. Hyattsville, MD: NCHS. 2009. Available from:
http://www.cdc.gov/nchs/data/nhsr/nhsr017.pdf.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Data Sources errors or small numbers of events have been noted with an
asterisk. The criteria used to designate or suppress unreliable
Data for the Health, United States, 2016, Chartbook come estimates are indicated in the notes to the applicable tables
from many surveys and data systems and cover a broad or charts.
range of years. Detailed descriptions of the data sources
included in the Chartbook are provided in Appendix I. Data For NCHS surveys, point estimates and their corresponding
Sources. Additional information clarifying and qualifying variances were calculated using the SUDAAN software
the data is included in the table notes and in Appendix II. package, which takes into consideration the complex survey
Definitions and Methods. design (135). Standard errors for other surveys or data sets
were computed using the methodology recommended by
the programs providing the data, or were provided directly
Data Presentation by those programs.
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Table 1 (page 1 of 3). Resident population, by age, sex, race, and Hispanic origin: United States, selected years 19502015
Excel and PDF versions (with more data years and standard errors when available): http://www.cdc.gov/nchs/hus/contents2016.htm#001.
[Data are based on the decennial census updated with data from multiple sources]
Age
Total
Sex, race, Hispanic resident Under 1 14 514 1524 2534 3544 4554 5564 6574 7584 85 years
origin, and year population year years years years years years years years years years and over
Age
Total
Sex, race, Hispanic resident Under 1 14 514 1524 2534 3544 4554 5564 6574 7584 85 years
origin, and year population year years years years years years years years years years and over
Black or
African American male Number, in thousands
1950 . . . . . . . . . . . . 7,300 -- 1
944 1,442 1,162 1,105 1,003 772 459 299 113
2
--
1960 . . . . . . . . . . . . 9,114 281 1,082 2,185 1,305 1,120 1,086 891 617 382 137 29
1970 . . . . . . . . . . . . 10,748 245 975 2,784 2,041 1,226 1,084 979 739 461 169 46
1980 . . . . . . . . . . . . 12,585 269 967 2,614 2,807 1,967 1,235 1,024 854 567 228 53
1990 . . . . . . . . . . . . 14,420 322 1,164 2,700 2,669 2,592 1,962 1,175 878 614 277 66
2000 . . . . . . . . . . . . 17,407 313 1,271 3,454 2,932 2,586 2,705 1,957 1,090 683 330 87
2010 . . . . . . . . . . . . 20,101 341 1,388 3,408 3,591 2,801 2,639 2,708 1,832 886 396 110
2013 . . . . . . . . . . . . 20,935 346 1,381 3,447 3,720 3,019 2,629 2,693 2,092 1,038 439 129
2014 . . . . . . . . . . . . 21,241 347 1,383 3,458 3,735 3,122 2,661 2,681 2,162 1,099 456 136
2015 . . . . . . . . . . . . 21,518 351 1,384 3,457 3,727 3,225 2,691 2,674 2,231 1,164 473 142
Black or
African American female
1950 . . . . . . . . . . . . 7,745 -- 1
941 1,446 1,300 1,260 1,112 796 443 322 125
2
--
1960 . . . . . . . . . . . . 9,758 283 1,085 2,191 1,404 1,300 1,229 974 663 430 160 38
1970 . . . . . . . . . . . . 11,832 243 970 2,773 2,196 1,456 1,309 1,134 868 582 230 71
1980 . . . . . . . . . . . . 14,046 266 951 2,578 2,937 2,267 1,488 1,258 1,059 776 360 106
1990 . . . . . . . . . . . . 16,063 316 1,137 2,641 2,700 2,905 2,279 1,416 1,135 884 495 156
2000 . . . . . . . . . . . . 19,187 302 1,228 3,348 2,971 2,866 3,055 2,274 1,353 971 587 233
2010 . . . . . . . . . . . . 21,965 330 1,343 3,292 3,568 3,066 2,962 3,056 2,197 1,192 675 282
2013 . . . . . . . . . . . . 22,762 331 1,333 3,333 3,630 3,224 2,950 3,043 2,499 1,378 723 318
2014 . . . . . . . . . . . . 23,069 332 1,333 3,349 3,630 3,305 2,984 3,029 2,578 1,460 741 328
2015 . . . . . . . . . . . . 23,345 336 1,336 3,350 3,607 3,383 3,013 3,022 2,654 1,544 763 339
American Indian or
Alaska Native male
1980 . . . . . . . . . . . . 702 17 59 153 161 114 75 53 37 22 9 2
1990 . . . . . . . . . . . . 1,024 24 88 206 192 183 140 86 55 32 13 3
2000 . . . . . . . . . . . . 1,488 28 109 301 271 229 229 165 88 45 18 5
2010 . . . . . . . . . . . . 2,143 39 160 381 392 336 290 264 167 76 29 7
2013 . . . . . . . . . . . . 2,240 40 157 388 396 356 299 272 194 95 35 9
2014 . . . . . . . . . . . . 2,269 40 156 389 395 362 302 274 201 102 37 10
2015 . . . . . . . . . . . . 2,299 40 156 389 393 367 307 276 210 108 40 11
American Indian or
Alaska Native female
1980 . . . . . . . . . . . 718 16 57 149 158 118 79 57 41 27 12 4
1990 . . . . . . . . . . . 1,041 24 85 200 178 186 148 92 61 41 21 6
2000 . . . . . . . . . . . 1,496 26 106 293 254 219 236 174 95 54 28 10
2010 . . . . . . . . . . . . 2,121 38 156 370 364 316 282 273 179 87 41 14
2013 . . . . . . . . . . . . 2,217 39 153 378 374 329 288 277 209 107 48 18
2014 . . . . . . . . . . . . 2,250 38 152 379 376 335 291 277 218 114 50 19
2015 . . . . . . . . . . . . 2,279 39 151 380 376 340 295 278 227 122 53 20
Asian or
Pacific Islander male
1980 . . . . . . . . . . . . 1,814 35 130 321 334 366 252 159 110 72 30 6
1990 . . . . . . . . . . . . 3,652 68 258 598 665 718 588 347 208 133 57 12
2000 . . . . . . . . . . . . 5,713 84 339 861 934 1,073 947 705 399 231 112 27
2010 . . . . . . . . . . . . 8,134 116 476 1,138 1,266 1,356 1,299 1,075 761 409 186 55
2013 . . . . . . . . . . . . 8,917 121 497 1,226 1,316 1,503 1,405 1,158 884 504 230 73
2014 . . . . . . . . . . . . 9,284 127 510 1,257 1,359 1,580 1,449 1,205 925 545 248 80
2015 . . . . . . . . . . . . 9,622 124 517 1,288 1,394 1,655 1,490 1,248 965 586 267 87
Age
Total
Sex, race, Hispanic resident Under 1 14 514 1524 2534 3544 4554 5564 6574 7584 85 years
origin, and year population year years years years years years years years years years and over
Asian or
Pacific Islander female Number, in thousands
1980 . . . . . . . . . . . . 1,915 34 127 307 325 423 269 192 126 71 33 9
1990 . . . . . . . . . . . . 3,805 65 247 578 621 749 664 371 264 166 65 17
2000 . . . . . . . . . . . . 6,044 81 336 817 914 1,112 1,024 812 451 305 152 41
2010 . . . . . . . . . . . . 8,859 110 460 1,124 1,223 1,498 1,450 1,223 920 491 267 93
2013 . . . . . . . . . . . . 9,713 116 479 1,202 1,279 1,628 1,580 1,309 1,064 615 313 127
2014 . . . . . . . . . . . . 10,114 121 489 1,230 1,322 1,702 1,634 1,366 1,111 670 331 138
2015 . . . . . . . . . . . . 10,480 118 493 1,259 1,357 1,771 1,684 1,417 1,155 726 350 150
Hispanic or Latino male
1980 . . . . . . . . . . . . 7,280 187 661 1,530 1,646 1,256 761 570 364 200 86 19
1990 . . . . . . . . . . . . 11,388 279 980 2,128 2,376 2,310 1,471 818 551 312 131 32
2000 . . . . . . . . . . . . 18,162 395 1,506 3,469 3,564 3,494 2,653 1,551 804 474 203 50
2010 . . . . . . . . . . . . 25,619 515 2,094 4,755 4,648 4,419 3,734 2,736 1,535 735 352 95
2013 . . . . . . . . . . . . 27,461 518 2,091 5,049 4,826 4,638 3,996 3,070 1,840 898 407 127
2014 . . . . . . . . . . . . 28,018 517 2,097 5,107 4,868 4,666 4,083 3,194 1,955 964 428 140
2015 . . . . . . . . . . . . 28,603 523 2,099 5,171 4,912 4,710 4,179 3,301 2,076 1,030 448 152
Hispanic or Latina female
1980 . . . . . . . . . . . . 7,329 181 634 1,482 1,546 1,249 805 615 411 257 117 30
1990 . . . . . . . . . . . . 10,966 268 939 2,039 2,028 2,073 1,448 868 632 403 209 59
2000 . . . . . . . . . . . . 17,144 376 1,441 3,318 3,017 3,016 2,476 1,585 907 603 303 101
2010 . . . . . . . . . . . . 24,859 497 2,008 4,561 4,206 4,016 3,564 2,728 1,679 914 510 176
2013 . . . . . . . . . . . . 26,610 496 2,013 4,844 4,449 4,124 3,794 3,011 1,979 1,089 580 230
2014 . . . . . . . . . . . . 27,370 496 2,021 4,920 4,551 4,215 3,910 3,136 2,099 1,166 607 248
2015 . . . . . . . . . . . . 27,989 501 2,020 4,987 4,617 4,273 3,997 3,239 2,214 1,242 633 267
White, not Hispanic or
Latino male
1980 . . . . . . . . . . . . 88,035 1,308 4,772 13,317 16,554 14,739 10,284 9,229 8,803 5,906 2,519 603
1990 . . . . . . . . . . . . 91,743 1,351 5,181 12,525 13,219 15,967 14,481 9,875 8,303 6,837 3,275 729
2000 . . . . . . . . . . . . 96,551 1,163 4,761 13,238 12,628 12,958 16,088 14,223 9,312 6,894 4,225 1,062
2010 . . . . . . . . . . . . 98,386 1,067 4,438 11,817 12,930 12,171 12,813 15,606 13,434 8,045 4,536 1,528
2013 . . . . . . . . . . . . 98,937 1,058 4,270 11,529 12,794 12,612 12,193 14,654 14,108 9,332 4,677 1,711
2014 . . . . . . . . . . . . 99,042 1,055 4,254 11,409 12,700 12,739 12,055 14,359 14,252 9,715 4,753 1,752
2015 . . . . . . . . . . . . 99,182 1,064 4,249 11,279 12,578 12,849 11,943 14,100 14,417 10,085 4,827 1,791
White, not Hispanic or
Latina female
1980 . . . . . . . . . . . . 92,872 1,240 4,522 12,647 16,185 14,711 10,468 9,700 9,935 7,707 4,345 1,411
1990 . . . . . . . . . . . . 96,557 1,280 4,909 11,846 12,749 15,872 14,520 10,153 9,116 8,674 5,491 1,945
2000 . . . . . . . . . . . . 100,774 1,102 4,517 12,529 12,183 12,778 16,089 14,446 9,879 8,188 6,429 2,633
2010 . . . . . . . . . . . . 101,741 1,016 4,225 11,219 12,426 11,972 12,718 15,839 14,049 9,000 6,125 3,150
2013 . . . . . . . . . . . . 101,982 1,007 4,063 10,958 12,194 12,358 12,073 14,844 14,785 10,314 6,064 3,321
2014 . . . . . . . . . . . . 102,007 1,007 4,047 10,852 12,083 12,460 11,927 14,522 14,938 10,730 6,102 3,338
2015 . . . . . . . . . . . . 102,060 1,014 4,039 10,735 11,936 12,551 11,806 14,242 15,113 11,124 6,146 3,354
1
Population for age group under 5 years.
2
Population for age group 75 years and over.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. Starting with Health, United States, 2003, population estimates for 19911999 are intercensal estimates based on the 1990
and 2000 censuses. Starting with Health, United States, 2012, population estimates for 20012009 are intercensal estimates based on the 2000 and 2010 censuses.
Population estimates for 2011 and beyond are 2010-based postcensal estimates. Population figures are census counts as of April 1 for 1950, 1960, 1970, 1980, and
1990. For 2000 and 2010, population estimates are bridged-race April 1 census counts. Estimates for other years are as of July 1. See Appendix I, Population Census
and Population Estimates. Populations for age groups may not sum to the total due to rounding. Unrounded population figures are available in the spreadsheet version
of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website
at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Census Bureau: 1950 Nonwhite Population by Race. Special Report P-E, No. 3B. Washington, DC: U.S. Government Printing Office, 1951; U.S. Census
of Population: 1960, Number of Inhabitants, PC(1)-A1, United States Summary, 1964; 1970, Number of Inhabitants, Final Report PC(1)-A1, United States Summary,
1971; U.S. population estimates, by age, sex, race, and Hispanic origin: 1980 to 1991. Current population reports, series P-25, no 1095. Washington, DC: U.S.
Government Printing Office, Feb. 1993; NCHS. Estimates of the July 1, 1991July 1, 1999; April 1, 2000; July 1, 2001July 1, 2009; April 1, 2010; July 1, 2011July 1,
2015 United States resident population by age, sex, race, and Hispanic origin, prepared under a collaborative arrangement with the U.S. Census Bureau, Population
Estimates Program. Available from: http://www.cdc.gov/nchs/nvss/bridged_race.htm. See Appendix I, Population Census and Population Estimates.
Selected characteristic,
race, and Hispanic origin 1 1973 1980 1990 2000 2 2010 4 2013(1) 4 2013(2) 4,5 2014 5 2015 5
Selected characteristic,
race, and Hispanic origin 1 1973 1980 1990 2000 2 2010 4 2013(1) 4 2013(2) 4,5 2014 5 2015 5
NOTES: Estimates of poverty for 19921998 were prepared using the 1990 census population controls. Estimates for 19992009 were prepared using the Census
2000-based population controls. Estimates for 2010 and beyond were prepared using the Census 2010-based population controls. Poverty level is based on family
income and family size using U.S. Census Bureau poverty thresholds. See Appendix II, Poverty. Poverty estimates based on a supplemental poverty measure are
available from the U.S. Census Bureau. In 20112013, an estimated 30.1% of American Indian or Alaska Native only persons (1,005,000 persons) were living below
the poverty level, and an estimated 15.9% of Native Hawaiian or Other Pacific Islander only persons (176,000 persons) were living below the poverty level. Due to the
redesign of the CPS ASEC income questions, 2013 is the last year that data were available to compute three-year estimates for the American Indian or Alaska Native
only populations and the Native Hawaiian or Other Pacific Islander populations. Estimates for these groups will not be updated until 2016 estimates are available. Data
for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement; Proctor BD, Semega JL, Kollar MA. Income and poverty in the
United States: 2015. Current Population Reports, P60256. Washington, DC: U.S. Government Printing Office. 2016. Available from:
http://www.census.gov/content/dam/Census/library/publications/2016/demo/p60-256.pdf. See Appendix I, Current Population Survey (CPS).
Age of mother
1519 years
Race, Crude
Hispanic origin, birth Fertility 1014 1517 1819 2024 2529 3034 3539 4044 4554
and year rate 1 rate 2 years Total years years years years years years years years 3
Age of mother
1519 years
Race, Crude
Hispanic origin, birth Fertility 1014 1517 1819 2024 2529 3034 3539 4044 4554
and year rate 1 rate 2 years Total years years years years years years years years 3
Asian or
Pacific Islander mother 5 Live births per 1,000 women
1980 . . . . . . . . . . . . . . . . . 19.9 73.2 0.3 26.2 12.0 46.2 93.3 127.4 96.0 38.3 8.5 0.7
1990 . . . . . . . . . . . . . . . . . 19.0 69.6 0.7 26.4 16.0 40.2 79.2 126.3 106.5 49.6 10.7 1.1
1995 . . . . . . . . . . . . . . . . . 16.7 62.6 0.7 25.5 15.6 40.1 64.2 103.7 102.3 50.1 11.8 0.8
2000 . . . . . . . . . . . . . . . . . 17.1 65.8 0.3 20.5 11.6 32.6 60.3 108.4 116.5 59.0 12.6 0.8
2005 . . . . . . . . . . . . . . . . . 15.9 63.0 0.2 15.4 7.7 26.4 52.9 96.6 115.3 61.8 13.7 1.0
2010 . . . . . . . . . . . . . . . . . 14.5 59.2 0.1 10.9 5.1 18.7 42.6 91.5 113.6 62.8 15.1 1.2
2012 . . . . . . . . . . . . . . . . . 15.1 62.2 0.1 9.7 4.1 17.7 41.4 95.8 121.3 68.1 16.1 1.4
2013 . . . . . . . . . . . . . . . . . 14.3 59.2 0.1 8.7 3.7 16.1 39.1 89.5 114.6 66.6 16.1 1.5
2014 . . . . . . . . . . . . . . . . . 14.6 60.7 0.1 7.7 3.3 13.9 37.5 90.0 121.3 68.9 16.1 1.5
2015 . . . . . . . . . . . . . . . . . 14.0 58.5 0.1 6.9 2.7 12.8 35.6 84.1 117.4 67.6 15.9 1.6
Hispanic or Latina mother 5,6
1980 . . . . . . . . . . . . . . . . . 23.5 95.4 1.7 82.2 52.1 126.9 156.4 132.1 83.2 39.9 10.6 0.7
1990 . . . . . . . . . . . . . . . . . 26.7 107.7 2.4 100.3 65.9 147.7 181.0 153.0 98.3 45.3 10.9 0.7
1995 . . . . . . . . . . . . . . . . . 24.1 98.8 2.6 99.3 68.3 145.4 171.9 140.4 90.5 43.7 10.7 0.6
2000 . . . . . . . . . . . . . . . . . 23.1 95.9 1.7 87.3 55.5 132.6 161.3 139.9 97.1 46.6 11.5 0.6
2005 . . . . . . . . . . . . . . . . . 22.9 96.4 1.3 76.5 45.8 124.4 161.1 147.0 105.6 53.3 12.8 0.8
2010 . . . . . . . . . . . . . . . . . 18.7 80.2 0.8 55.7 32.3 90.7 126.1 125.3 96.6 51.7 13.0 0.8
2012 . . . . . . . . . . . . . . . . . 17.1 74.4 0.6 46.3 25.5 77.2 111.5 119.6 94.3 51.6 13.2 0.8
2013 . . . . . . . . . . . . . . . . . 16.7 72.9 0.5 41.7 22.0 70.8 107.2 119.1 94.8 52.4 13.3 0.8
2014 . . . . . . . . . . . . . . . . . 16.5 72.1 0.4 38.0 19.3 66.1 104.5 118.7 96.5 53.6 13.5 0.9
2015 . . . . . . . . . . . . . . . . . 16.3 71.7 0.4 34.9 17.4 61.9 102.1 119.3 98.6 54.5 14.0 0.9
White, not Hispanic or
Latina mother 5,6
1980 . . . . . . . . . . . . . . . . . 14.2 62.4 0.4 41.2 22.4 67.7 105.5 110.6 59.9 17.7 3.0 0.1
1990 . . . . . . . . . . . . . . . . . 14.4 62.8 0.5 42.5 23.2 66.6 97.5 115.3 79.4 30.0 4.7 0.2
1995 . . . . . . . . . . . . . . . . . 12.5 57.5 0.4 39.3 22.0 66.2 90.2 105.1 81.5 32.8 5.9 0.3
2000 . . . . . . . . . . . . . . . . . 12.2 58.5 0.3 32.6 15.8 57.5 91.2 109.4 93.2 38.8 7.3 0.4
2005 . . . . . . . . . . . . . . . . . 11.6 59.0 0.2 26.0 11.5 48.0 82.7 111.7 98.4 46.0 8.3 0.5
2010 . . . . . . . . . . . . . . . . . 10.9 58.7 0.2 23.5 10.0 42.5 74.9 105.8 99.9 44.1 9.2 0.6
2012 . . . . . . . . . . . . . . . . . 10.7 58.6 0.2 20.5 8.4 37.9 70.2 104.4 100.5 46.8 9.1 0.6
2013 . . . . . . . . . . . . . . . . . 10.7 58.7 0.1 18.6 7.4 35.0 68.3 103.5 101.9 48.0 9.1 0.7
2014 . . . . . . . . . . . . . . . . . 10.8 59.5 0.1 17.3 6.7 32.9 67.1 103.9 104.7 49.6 9.1 0.7
2015 . . . . . . . . . . . . . . . . . 10.7 59.3 0.1 16.0 6.0 30.6 65.0 102.3 105.1 50.6 9.4 0.7
Black or African American,
not Hispanic or Latina mother 5,6
1980 . . . . . . . . . . . . . . . . . 22.9 90.7 4.6 105.1 77.2 146.5 152.2 111.7 65.2 25.8 5.8 0.3
1990 . . . . . . . . . . . . . . . . . 23.0 89.0 5.0 116.2 84.9 157.5 165.1 118.4 70.2 28.7 5.6 0.3
1995 . . . . . . . . . . . . . . . . . 18.2 72.8 4.2 97.2 70.4 139.2 137.8 98.5 64.4 28.8 6.1 0.3
2000 . . . . . . . . . . . . . . . . . 17.3 71.4 2.4 79.2 50.1 121.9 145.4 102.8 66.5 31.8 7.2 0.4
2005 . . . . . . . . . . . . . . . . . 15.8 67.2 1.6 59.4 34.1 100.2 127.9 105.5 68.8 34.2 8.2 0.5
2010 . . . . . . . . . . . . . . . . . 15.1 66.6 1.0 51.5 27.4 85.6 119.4 102.5 73.6 36.4 9.2 0.7
2012 . . . . . . . . . . . . . . . . . 14.6 65.0 0.8 43.9 21.9 74.1 109.0 101.7 75.1 38.9 9.6 0.7
2013 . . . . . . . . . . . . . . . . . 14.4 64.6 0.7 39.0 18.9 67.0 105.6 102.7 77.3 40.3 9.9 0.8
2014 . . . . . . . . . . . . . . . . . 14.4 64.5 0.6 34.9 16.6 61.5 102.8 103.3 79.6 42.5 10.1 0.9
2015 . . . . . . . . . . . . . . . . . 14.2 64.1 0.6 31.8 15.3 56.7 100.2 102.0 81.6 43.6 10.7 0.9
See footnotes at end of table.
1
Live births per 1,000 population.
2
Total number of live births regardless of age of mother per 1,000 women aged 1544.
3
Prior to 1997, data are for live births to mothers aged 4549 per 1,000 women aged 4549. In subsequent years, rates were computed by dividing the number of births
to women aged 45 and over by the population of women aged 4549. See Appendix II, Age.
4
Live births are tabulated by race of child. See Appendix II, Race.
5
Live births are tabulated by race and/or Hispanic origin of mother. See Appendix II, Race.
6
Prior to 1993, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin. Rates in 1985 were not
calculated because estimates for the Hispanic and non-Hispanic populations were not available.
NOTES: Data are based on births adjusted for underregistration for 1950 and on registered births for all other years. Starting with 1970 data, births to persons who were
not residents of the 50 states and the District of Columbia are excluded. Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal
population estimates based on the 1990 and 2000 censuses. Rates for 2000 were based on bridged-race April 1, 2000 census counts. Starting with Health, United
States, 2012, rates for 20012009 were revised using intercensal population estimates based on the 2000 and 2010 censuses. Rates for 2010 were based on bridged-
race April 1, 2010 census counts. Rates for 2011 and beyond were computed using 2010-based postcensal estimates. See Appendix I, Population Census and
Population Estimates. The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic
origin. Persons of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were
bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Interpretation
of trend data for Hispanic women should take into consideration expansion of reporting areas. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for 2015.
National vital statistics report, vol 66, no 1. Hyattsville, MD: NCHS. 2017. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. Ventura SJ. Births
of Hispanic parentage, 1980 and 1985. Monthly vital statistics report; vol 32 no 6 and vol 36 no 11, suppl. Public Health Service. Hyattsville, MD. 1983 and 1988;
Available from: http://www.cdc.gov/nchs/data/mvsr/supp/mv32_06sacc.pdf and http://www.cdc.gov/nchs/data/mvsr/supp/mv36_11s.pdf. Internet release of: Vital
statistics of the United States, 2003, vol 1, Natality, Tables 11 and 17; available from: http://www.cdc.gov/nchs/products/vsus.htm#electronic. See Appendix I,
National Vital Statistics System (NVSS).
Maternal race,
Hispanic origin, and age 1970 1980 1990 1995 2000 2005 2010 2013 2014 2015
All races and origins . . . . . . . . . . . . . . . 26.4 29.4 43.8 44.3 44.1 47.2 47.5 44.3 43.9 43.4
White 2 . . . . . . . . . . . . . . . . . . . . . . . 13.9 18.1 32.9 37.0 38.2 43.2 44.5 40.8 40.6 40.4
Black or African American 2 . . . . . . . . . . . 95.5 81.1 90.5 74.5 70.5 67.2 65.3 61.7 61.5 59.6
Asian or Pacific Islander . . . . . . . . . . . . . -- -- -- -- 20.9 22.8 22.3 21.8 21.7 20.4
Hispanic or Latina 3 . . . . . . . . . . . . . . . . -- -- 89.6 88.8 87.2 96.2 80.6 69.9 68.5 67.4
White, not Hispanic or Latina 3 . . . . . . . . . -- -- 24.4 28.1 28.0 30.4 32.9 31.7 31.8 31.6
Percent of live births to unmarried mothers
All races and origins . . . . . . . . . . . . . . . 10.7 18.4 28.0 32.2 33.2 36.9 40.8 40.6 40.2 40.3
White . . . . . . . . . . . . . . . . . . . . . . . . 5.5 11.2 20.4 25.3 27.1 31.7 35.9 35.8 35.7 35.8
Black or African American . . . . . . . . . . . . 37.5 56.1 66.5 69.9 68.5 69.3 72.1 71.0 70.4 70.1
American Indian or Alaska Native . . . . . . . 22.4 39.2 53.6 57.2 58.4 63.5 65.6 66.4 65.7 65.8
Asian or Pacific Islander 4 . . . . . . . . . . . . -- 7.3 13.2 16.3 14.8 16.2 17.0 17.0 16.4 16.4
Hispanic or Latina 3 . . . . . . . . . . . . . . . . -- 23.6 36.7 40.8 42.7 48.0 53.4 53.2 52.9 53.0
Mexican . . . . . . . . . . . . . . . . . . . . . -- 20.3 33.3 38.1 40.7 46.7 52.0 51.9 51.6 51.5
Puerto Rican . . . . . . . . . . . . . . . . . . -- 46.3 55.9 60.0 59.6 61.7 65.2 64.6 63.9 64.2
Cuban . . . . . . . . . . . . . . . . . . . . . . -- 10.0 18.2 23.8 27.3 36.4 47.0 50.1 49.8 50.7
Central and South American . . . . . . . . . -- 27.1 41.2 44.1 44.7 49.2 51.8 50.1 50.4 51.0
Other and unknown Hispanic or Latina . . -- 22.4 37.2 44.0 46.2 48.6 56.3 56.1 55.5 55.1
Not Hispanic or Latina: 3
White . . . . . . . . . . . . . . . . . . . . . . -- 9.5 16.9 21.2 22.1 25.3 29.0 29.3 29.2 29.2
Black or African American . . . . . . . . . . -- 57.2 66.7 70.0 68.7 69.9 72.5 71.5 70.9 70.5
Number of live births, in thousands
Live births to unmarried mothers . . . . . . . . 399 666 1,165 1,254 1,347 1,527 1,633 1,596 1,605 1,602
Maternal age Percent distribution of live births to unmarried mothers
Under 20 years . . . . . . . . . . . . . . . . . . 50.1 40.8 30.9 30.9 28.0 23.1 20.1 15.4 13.9 12.9
2024 years . . . . . . . . . . . . . . . . . . . . 31.8 35.6 34.7 34.5 37.4 38.3 36.8 36.8 36.1 35.0
25 years and over . . . . . . . . . . . . . . . . . 18.1 23.5 34.4 34.7 34.6 38.7 43.1 47.9 50.0 52.1
NOTES: National estimates for 1970 and 1975 (shown in spreadsheet version) for unmarried mothers are based on births occurring in states reporting marital status
of mother. Changes in reporting procedures for marital status occurred in some states during the 1990s. Data for states in which marital status was not reported
have been inferred and included with data from the remaining states. See Appendix II, Marital status. Interpretation of trend data for Hispanic births should take into
consideration expansion of reporting areas. The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for
these states were bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix
II, Race. Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
Rates for 2000 were based on bridged-race April 1, 2000 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. Rates for 2010 were based on 2010 bridged-race April 2010 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for 2015.
National vital statistics report, vol 66, no 1. Hyattsville, MD: NCHS. 2017. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. Hamilton BE,
Sutton PD, Ventura SJ. Revised birth and fertility rates for the 1990s and new rates for Hispanic populations, 2000 and 2001: United States. National vital statistics
reports; vol 51 no 12. Hyattsville, MD: NCHS. 2003; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_12.pdf. Births: Final data for each data year
19972007. National vital statistics reports. Hyattsville, MD; Final natality statistics for each data year 19931996. Monthly vital statistics report. Hyattsville, MD; Ventura
SJ. Births to unmarried mothers: United States, 19801992. Vital Health Stat 21(53). 1995. See Appendix I, National Vital Statistics System (NVSS).
Low birthweight
(less than 2,500 grams) Percent of live births 1
All races . . . . . . . . . . . . . . . . . . . . . . 7.93 7.38 6.84 6.97 7.57 8.19 8.15 8.02 8.00 8.07
White . . . . . . . . . . . . . . . . . . . . . . . . 6.85 6.27 5.72 5.70 6.55 7.16 7.08 7.00 6.98 7.00
Black or African American . . . . . . . . . . . . 13.90 13.19 12.69 13.25 12.99 13.59 13.21 12.76 12.83 13.03
American Indian or Alaska Native . . . . . . . 7.97 6.41 6.44 6.11 6.76 7.36 7.61 7.48 7.65 7.53
Asian or Pacific Islander 2 . . . . . . . . . . . . -- -- 6.68 6.45 7.31 7.98 8.49 8.34 8.05 8.40
Hispanic or Latina 3 . . . . . . . . . . . . . . . . -- -- 6.12 6.06 6.41 6.88 6.97 7.09 7.05 7.21
Mexican . . . . . . . . . . . . . . . . . . . . . -- -- 5.62 5.55 6.01 6.49 6.49 6.62 6.58 6.81
Puerto Rican . . . . . . . . . . . . . . . . . . -- -- 8.95 8.99 9.30 9.92 9.55 9.38 9.54 9.42
Cuban . . . . . . . . . . . . . . . . . . . . . . -- -- 5.62 5.67 6.49 7.64 7.30 7.35 7.48 7.16
Central and South American . . . . . . . . . -- -- 5.76 5.84 6.34 6.78 6.55 6.85 6.68 6.74
Other and unknown Hispanic or Latina . . -- -- 6.96 6.87 7.84 8.27 8.38 7.99 7.94 8.13
Not Hispanic or Latina: 3
White . . . . . . . . . . . . . . . . . . . . . . -- -- 5.69 5.61 6.60 7.29 7.14 6.98 6.96 6.93
Black or African American . . . . . . . . . . -- -- 12.71 13.32 13.13 14.02 13.53 13.08 13.17 13.35
Very low birthweight
(less than 1,500 grams)
All races . . . . . . . . . . . . . . . . . . . . . . 1.17 1.16 1.15 1.27 1.43 1.49 1.45 1.41 1.40 1.40
White . . . . . . . . . . . . . . . . . . . . . . . . 0.95 0.92 0.90 0.95 1.14 1.20 1.17 1.14 1.14 1.12
Black or African American . . . . . . . . . . . . 2.40 2.40 2.48 2.92 3.07 3.15 2.90 2.82 2.79 2.81
American Indian or Alaska Native . . . . . . . 0.98 0.95 0.92 1.01 1.16 1.17 1.28 1.32 1.27 1.27
Asian or Pacific Islander 2 . . . . . . . . . . . . -- -- 0.92 0.87 1.05 1.14 1.17 1.18 1.15 1.13
Hispanic or Latina 3 . . . . . . . . . . . . . . . . -- -- 0.98 1.03 1.14 1.20 1.20 1.21 1.23 1.23
Mexican . . . . . . . . . . . . . . . . . . . . . -- -- 0.92 0.92 1.03 1.12 1.09 1.13 1.13 1.13
Puerto Rican . . . . . . . . . . . . . . . . . . -- -- 1.29 1.62 1.93 1.87 1.82 1.65 1.86 1.73
Cuban . . . . . . . . . . . . . . . . . . . . . . -- -- 1.02 1.20 1.21 1.50 1.42 1.27 1.45 1.38
Central and South American . . . . . . . . . -- -- 0.99 1.05 1.20 1.19 1.09 1.15 1.12 1.13
Other and unknown Hispanic or Latina . . -- -- 1.01 1.09 1.42 1.36 1.46 1.37 1.38 1.44
Not Hispanic or Latina: 3
White . . . . . . . . . . . . . . . . . . . . . . -- -- 0.87 0.93 1.14 1.21 1.16 1.11 1.10 1.09
Black or African American . . . . . . . . . . -- -- 2.47 2.93 3.10 3.27 2.98 2.90 2.87 2.89
1
Excludes live births with unknown birthweight. Percentage based on live births with known birthweight. See Appendix II, Birthweight.
2
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Interpretation of trend data
for Hispanic births should take into consideration expansion of reporting areas. Data for additional years are available. See the Excel spreadsheet on the Health, United
States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for 2015.
National vital statistics report, vol 66, no 1. Hyattsville, MD: NCHS. 2017. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. See Appendix I,
National Vital Statistics System (NVSS).
United States 2. . . . . . . 7.69 8.07 8.03 6.75 7.18 6.96 13.19 13.77 13.20
Alabama . . . . . . . 9.75 10.35 10.17 7.77 8.46 8.03 14.10 15.02 15.17
Alaska . . . . . . . . . . 5.71 6.02 5.81 4.84 5.34 5.37 10.70 11.74 8.15
Arizona . . . . . . . . . 6.91 7.05 7.03 6.78 7.01 6.58 13.16 12.38 11.77
Arkansas . . . . . . . . 8.64 9.04 8.95 7.48 7.83 7.71 13.81 14.86 14.59
California . . . . . . . . 6.29 6.71 6.78 5.86 6.30 5.91 11.66 12.46 11.46
Colorado . . . . . . . . 8.60 9.04 8.86 8.24 8.81 8.35 14.59 15.20 13.48
Connecticut. . . . . . . 7.52 7.74 7.79 6.48 6.60 6.58 12.28 12.88 12.23
Delaware . . . . . . . . 9.29 9.31 8.63 7.80 7.62 7.05 14.08 14.32 12.72
District of Columbia . . 11.85 11.06 9.76 6.35 6.28 6.19 14.60 13.96 12.83
Florida . . . . . . . . . . 8.18 8.59 8.60 6.98 7.38 7.16 12.58 13.28 13.11
Georgia . . . . . . . . . 8.79 9.27 9.47 6.92 7.44 7.14 12.98 13.81 13.69
Hawaii . . . . . . . . . . 7.98 8.23 8.15 6.17 6.42 5.88 11.01 11.44 11.90
Idaho. . . . . . . . . . . 6.41 6.65 6.64 6.29 6.60 6.49 * *7.03 9.39
Illinois . . . . . . . . . . 8.04 8.40 8.22 6.74 7.22 6.85 14.04 14.70 13.76
Indiana. . . . . . . . . . 7.54 8.10 7.97 6.95 7.54 7.33 12.89 13.46 12.87
Iowa . . . . . . . . . . . 6.39 6.92 6.68 6.19 6.72 6.36 11.77 12.22 10.85
Kansas . . . . . . . . . 6.96 7.28 6.96 6.66 6.97 6.56 12.37 13.42 12.39
Kentucky . . . . . . . . 8.38 8.86 8.71 7.84 8.50 8.33 13.84 13.52 13.40
Louisiana . . . . . . . . 10.40 11.02 10.67 7.56 8.12 8.02 14.44 15.33 15.20
Maine . . . . . . . . . . 6.12 6.58 7.20 6.13 6.57 7.04 *9.47 8.47 9.87
Maryland . . . . . . . 8.88 9.17 8.54 6.79 7.19 6.61 13.00 13.13 11.95
Massachusetts . . . . . 7.26 7.77 7.54 6.56 7.15 6.76 11.54 11.82 10.45
Michigan . . . . . . . . 7.94 8.28 8.36 6.55 7.00 6.98 14.24 14.43 13.74
Minnesota . . . . . . . . 6.23 6.43 6.46 5.80 5.93 5.86 10.54 10.71 9.32
Mississippi . . . . . . . 10.82 11.62 11.42 7.97 8.67 8.07 14.48 15.60 16.05
Missouri . . . . . . . . . 7.74 8.12 8.18 6.79 7.18 7.10 13.27 13.90 14.07
Montana . . . . . . . . . 6.65 7.02 7.28 6.60 6.81 6.90 * *15.58 *13.58
Nebraska . . . . . . . . 6.88 6.97 6.73 6.52 6.76 6.19 13.07 12.16 12.05
Nevada . . . . . . . . . 7.44 8.11 8.28 7.19 7.78 7.59 13.40 13.98 13.32
New Hampshire . . . . 6.40 6.65 6.87 6.24 6.59 6.77 10.58 10.85 10.14
New Jersey . . . . . . 7.89 8.19 8.14 6.59 7.11 6.88 13.20 13.48 12.42
New Mexico . . . . . . 7.99 8.38 8.79 7.89 8.33 8.50 13.88 15.01 14.47
New York . . . . . . . . 7.76 8.11 7.88 6.48 6.82 6.50 12.02 12.78 12.08
North Carolina . . . . . 8.90 9.07 8.92 7.49 7.73 7.39 13.83 14.33 13.74
North Dakota . . . . . . 6.28 6.49 6.26 6.13 6.37 6.08 *9.02 *9.43 8.41
Ohio . . . . . . . . . . . 8.07 8.51 8.49 7.08 7.53 7.33 13.45 13.83 13.61
Oklahoma . . . . . . . . 7.75 7.92 7.96 7.35 7.63 7.53 13.57 13.62 13.34
Oregon . . . . . . . . . 5.65 6.09 6.31 5.44 6.02 5.99 10.32 11.16 9.47
Pennsylvania . . . . . . 7.93 8.20 8.15 6.78 7.06 6.98 13.79 13.67 12.96
Rhode Island . . . . . . 7.47 8.12 7.19 6.75 7.39 6.30 12.32 11.22 10.63
South Carolina . . . . 9.74 10.15 9.55 7.40 7.82 7.38 14.29 15.19 14.39
South Dakota . . . . . . 6.58 6.71 6.31 6.37 6.62 6.00 *11.51 *7.27 8.06
Tennessee . . . . . . . 9.20 9.35 9.09 7.95 8.26 7.86 14.23 14.51 14.19
Texas . . . . . . . . . . 7.54 8.07 8.25 6.81 7.43 7.23 12.82 13.91 13.16
Utah . . . . . . . . . . . 6.48 6.68 7.00 6.28 6.45 6.68 13.09 12.05 9.48
Vermont . . . . . . . . . 6.15 6.57 6.80 6.12 6.55 6.63 * * *9.01
Virginia . . . . . . . . . 7.90 8.23 7.91 6.54 7.01 6.57 12.56 12.83 12.29
Washington . . . . . . . 5.75 6.13 6.43 5.43 5.63 5.89 10.34 10.63 9.87
West Virginia . . . . . . 8.60 9.16 9.36 8.39 9.03 9.21 13.81 13.15 13.58
Wisconsin . . . . . . . . 6.58 6.93 7.20 5.83 6.18 6.27 13.25 13.59 14.04
Wyoming . . . . . . . . 8.35 8.71 8.79 8.12 8.74 8.45 *13.29 * *10.55
American Samoa 3 . . 3.51 3.75 3.68 -- -- -- -- -- --
Guam 3 . . . . . . . . . . 7.88 8.81 8.65 *4.13 *4.01 * * * *
Northern Marianas 3 . . 8.05 7.55 7.73 -- -- -- --
Puerto Rico 3 . . . . . . 11.14 11.92 10.63 -- -- 10.83 -- -- 14.07
Virgin Islands 3 . . . . . 10.21 11.14 -- *8.37 *5.90 -- 9.89 12.51 --
See footnotes at end of table.
Alabama . . . . . . . . . 6.95 6.92 6.96 9.68 10.53 8.51 7.38 8.02 8.96
Alaska . . . . . . . . . . 6.07 5.31 5.80 5.81 5.86 6.25 7.33 6.57 6.51
Arizona . . . . . . . . . 6.56 6.69 6.79 6.85 7.11 7.01 7.95 7.92 8.31
Arkansas . . . . . . . . 5.79 6.54 6.45 8.11 8.86 6.77 7.73 6.74 9.09
California . . . . . . . . 5.66 6.10 6.40 6.21 6.49 7.12 7.15 7.42 7.57
Colorado . . . . . . . . 8.33 8.53 8.72 9.05 9.45 9.40 10.17 10.26 10.96
Connecticut. . . . . . . 8.25 8.49 8.18 10.06 7.45 11.11 8.07 7.83 8.08
Delaware . . . . . . . . 6.81 7.03 7.08 * * * 9.89 9.33 7.96
District of Columbia . . 8.04 7.46 7.37 * * * *7.00 8.97 6.99
Florida . . . . . . . . . . 6.61 6.98 7.27 7.11 7.38 6.75 8.35 8.73 8.86
Georgia . . . . . . . . . 5.77 5.96 6.85 9.29 9.00 9.66 8.18 8.35 8.39
Hawaii . . . . . . . . . . 8.00 8.34 8.35 *4.99 * * 8.45 8.84 9.03
Idaho. . . . . . . . . . . 6.95 6.67 7.01 6.15 8.31 7.26 7.38 6.67 7.16
Illinois . . . . . . . . . . 6.31 6.60 6.92 8.60 9.46 7.81 8.49 8.28 9.20
Indiana. . . . . . . . . . 6.09 6.33 6.70 *7.74 *10.00 *9.41 7.41 7.87 7.68
Iowa . . . . . . . . . . . 6.01 6.12 6.20 7.23 9.15 6.29 7.13 7.71 8.24
Kansas . . . . . . . . . 5.93 6.09 6.02 6.20 7.09 5.27 6.69 7.34 8.16
Kentucky . . . . . . . . 7.73 6.85 6.38 *7.17 *8.54 *9.35 7.75 7.56 8.01
Louisiana . . . . . . . . 6.56 7.62 6.98 9.06 10.11 7.46 7.89 8.46 8.97
Maine . . . . . . . . . . *6.03 *4.74 *7.23 * * *9.31 *5.46 8.69 9.32
Maryland . . . . . . . . 6.73 7.18 7.06 9.74 10.87 6.68 7.42 7.93 8.21
Massachusetts . . . . . 8.37 8.41 8.20 *7.11 *7.62 *7.16 7.57 7.63 8.14
Michigan . . . . . . . . 6.26 6.46 7.11 7.26 6.98 7.58 7.46 8.33 8.73
Minnesota . . . . . . . . 6.02 5.70 6.34 7.10 6.87 8.40 7.28 7.43 7.48
Mississippi . . . . . . . 6.61 6.42 6.64 7.30 6.24 *6.07 6.83 8.06 7.65
Missouri . . . . . . . . . 6.18 6.33 6.89 8.67 7.63 8.54 7.34 7.61 7.84
Montana . . . . . . . . . 7.44 8.63 7.58 7.14 7.80 9.05 *5.95 *8.70 *9.93
Nebraska . . . . . . . . 6.30 6.20 6.46 7.27 6.78 6.82 8.05 7.61 8.03
Nevada . . . . . . . . . 6.34 6.74 7.15 6.80 7.58 7.02 7.56 10.35 9.28
New Hampshire . . . . 4.84 6.55 6.78 * * * 5.95 7.75 7.79
New Jersey . . . . . . . 7.15 7.27 7.50 11.09 9.83 10.52 7.57 8.10 8.96
New Mexico . . . . . . 8.13 8.45 8.91 6.88 7.32 7.87 7.67 8.60 9.50
New York . . . . . . . . 7.38 7.59 7.72 7.81 7.31 7.45 7.33 7.89 8.26
North Carolina . . . . . 6.13 6.27 6.75 10.30 11.01 10.90 8.20 7.77 8.09
North Dakota . . . . . . *8.10 *5.84 5.75 6.62 6.78 6.75 * *8.39 6.62
Ohio . . . . . . . . . . . 7.20 7.13 7.85 8.86 10.22 9.64 7.86 8.27 8.59
Oklahoma . . . . . . . . 6.41 6.46 6.92 6.48 6.69 7.01 7.87 6.82 7.94
Oregon . . . . . . . . . 5.54 5.43 6.41 7.23 7.34 6.85 6.78 7.00 7.84
Pennsylvania . . . . . . 8.97 9.00 8.75 9.15 10.95 9.92 7.48 7.99 8.70
Rhode Island . . . . . . 7.20 8.61 7.79 *10.32 13.66 *8.86 9.31 10.11 7.98
South Carolina . . . . . 6.87 6.66 6.68 10.22 10.75 *7.38 8.02 8.13 8.62
South Dakota . . . . . . 6.89 5.94 7.07 6.84 7.04 6.95 *11.39 *9.50 8.38
Tennessee . . . . . . . 6.28 6.04 6.61 *7.11 *6.63 8.11 8.60 7.76 8.06
Texas . . . . . . . . . . 6.88 7.23 7.62 6.67 7.33 6.63 7.78 8.33 9.45
Utah . . . . . . . . . . . 7.20 7.26 7.72 6.37 7.46 7.67 7.23 8.20 8.68
Vermont . . . . . . . . . * * *8.98 * * * * *8.08 *9.57
Virginia . . . . . . . . . 6.07 6.28 6.58 *10.73 *9.20 7.92 7.50 7.71 8.15
Washington . . . . . . . 5.31 5.93 6.11 7.08 7.31 7.48 6.37 6.90 7.85
West Virginia . . . . . . * *6.06 8.67 * * * *9.16 *9.51 *7.22
Wisconsin . . . . . . . . 6.13 6.34 6.69 6.12 6.04 6.56 6.97 7.50 7.72
Wyoming . . . . . . . . 8.81 8.43 9.72 9.55 8.39 10.30 *12.04 * *9.84
* Percentages preceded by an asterisk are based on fewer than 50 births. Percentages not shown are based on fewer than 20 births.
Quantity zero.
1
Excludes live births with unknown birthweight.
2
Excludes data for American Samoa, Guam, Northern Marianas, Puerto Rico, and Virgin Islands.
3
Comparable data were not available for all time periods and racial and ethnicity groups. Therefore, only selected low birthweight percentages are presented for
the territories.
4
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
5
Includes persons of Hispanic and non-Hispanic origin.
NOTES: For information on low birthweight live births by state, see Table I-9 in Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for
2015. National vital statistics report, vol 66, no 1. Hyattsville, MD: NCHS. 2017. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. Starting with
2003 data, some states and territories reported multiple-race data. The multiple-race data for these areas were bridged to the single-race categories of the 1977 Office
of Management and Budget standards, for comparability with other areas. See Appendix II, Race. Data for the territories are shown by race and ethnicity only if race-
specific data are available for all years in the 3-year period. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Mathews TJ. Births: Final data for 2015.
National vital statistics report, vol 66, no 1. Hyattsville, MD: NCHS. 2017. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. See Appendix I,
National Vital Statistics System (NVSS).
Data provider 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
NOTES: Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City).
This information is provided voluntarily to CDC. See the annual Abortion Surveillance reports for more information on the characteristic-specific list of reporting areas.
Available from: http://www.cdc.gov/reproductivehealth/Data_Stats/Abortion.htm. For methodological differences between CDC and the Guttmacher Institute Abortion
Provider Census, see Appendix I, Abortion Surveillance System; Guttmacher Institute Abortion Provider Census. Some data were revised and differ from previous
editions of Health, United States.
SOURCE: CDC, National Center for Chronic Disease Prevention and Health Promotion. CDC. Abortion surveillanceUnited States, 2013. MMWR 2016;65(SS12);144.
Available from: http://www.cdc.gov/mmwr/volumes/65/ss/ss6512a1.htm. Guttmacher Institute Abortion Provider Survey. Perspect Sex Reprod Health 2014;46(1):314.
Available from: http://www.guttmacher.org/pubs/journals/psrh.46e0414.pdf. See Appendix I, Abortion Surveillance System; Guttmacher Institute Abortion Provider
Census.
Age, in years
Race and Hispanic origin and year 1
1544 1519 2024 2534 3544
Age, in years
Race and Hispanic origin and year 1
1544 1519 2024 2534 3544
Age, in years
Method of contraception and year 1544 1519 2024 2534 3544
Age, in years
Method of contraception and year 1544 1519 2024 2534 3544
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%
Quantity zero.
1
Starting with 1995 data, race-specific estimates are tabulated according to 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. Starting with 1995 data, race-specific estimates are for persons who reported only one racial
group. Prior to data year 1995, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1995 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Race.
2
Includes women of other or multiple race not shown separately.
3
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
4
Includes women using contraception in the month of interview, or not using contraception in the month of interview but had sexual intercourse in the three months
prior to interview.
5
Data collected starting with the 1995 survey. Includes data about the contraceptive patch, with data collection starting in the 2002 survey, and the contraceptive ring,
6
Data collected starting with the 1995 survey.
7
In 20112015, includes the oral contraceptive pill only. In previous tables, includes the oral contraceptive pill and emergency contraception/morning-after pill.
8
In 20112015, includes emergency contraception, female condom/vaginal pouch, foam, cervical cap, Today sponge, suppository or insert, jelly or cream (without
diaphragm), and other method. In 20062010, includes the contraceptive ring, female condom/vaginal pouch, foam, cervical cap, Today brand sponge, suppository or
insert, jelly or cream (without diaphragm), and other method. In 2002, includes female condom, foam, cervical cap, Today sponge, suppository or insert, jelly or cream
(without diaphragm), or other method. In 1995, includes the female condom or vaginal pouch, foam, cervical cap, Today sponge, suppository or insert, jelly or cream,
or other method. In 1988 (in spreadsheet version), includes foam, douche, Today sponge, suppository or insert, jelly or cream, or other method. In 1982, includes foam,
douche, suppository or insert, or other method.
NOTES: Survey collects up to four methods of contraception used in the month of interview. See Appendix II, Contraception. Percents may not add to the total because
more than one method could have been used in the month of interview. Standard errors for selected years are available in the spreadsheet version of this table.
Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Survey of Family Growth. See Appendix I, National Survey of Family Growth (NSFG).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%.
1
Starting with 1995 data, race-specific estimates are tabulated according to 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. Starting with 1995 data, race-specific estimates are for persons who reported only one racial
group. Prior to data year 1995, data were tabulated according to the 1977 Standards. Estimates for single race categories prior to 1995 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Race.
2
Educational attainment is presented only for women aged 2244. Education is as of date of interview. GED is General Educational Development high school
equivalency diploma. See Appendix II, Education.
3
See Appendix II, Geographic region.
NOTES: Data are based on single births to mothers aged 1544 at interview, including those births that occurred when the mothers were younger than age 15. Data on
breastfeeding for babies born in 19861994 are based on women interviewed for the 1995 National Survey of Family Growth (NSFG), also known as Cycle 5. Data for
babies born in 19952001 are based on women interviewed for the 2002 NSFG, also known as Cycle 6. Data for babies born in 20022004 and 20052007 are based
on women interviewed for the 20062010 NSFG, conducted after NSFG's transition from periodic to continuous interviewing. Data for babies born in 20082010 and
20112013 are based on women interviewed for the 20112015 NSFG. Data for babies born in 20082010 have been revised and differ from previous editions of
Health, United States. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Survey of Family Growth. See Appendix I, National Survey of Family Growth (NSFG).
Fetal 8,9 deaths per 1,000 live births plus fetal deaths
All mothers . . . . . . . . . . . . . . . . . . . -- -- -- 7.0 6.6 6.2 6.0 6.0 6.0
Hispanic or Latina 5 . . . . . . . . . . . . . . . -- -- -- -- 5.8 5.4 5.2 5.2 5.1
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 5.3 4.8 4.8 4.9 4.9
Black or African American . . . . . . . . . . -- -- -- -- 12.0 11.1 10.8 10.5 10.7
Late fetal 8,10 deaths per 1,000 live births plus late fetal deaths
All mothers . . . . . . . . . . . . . . . . . . . -- -- -- 3.6 3.3 3.0 3.0 3.0 2.8
Hispanic or Latina 5 . . . . . . . . . . . . . . . -- -- -- -- 3.1 2.8 2.6 2.7 2.5
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 2.8 2.4 2.5 2.6 2.4
Black or African American . . . . . . . . . . -- -- -- -- 5.2 4.8 4.7 4.7 4.6
Perinatal 8,11 deaths per 1,000 live births plus late fetal deaths
All mothers . . . . . . . . . . . . . . . . . . . -- -- -- 7.6 7.0 6.6 6.2 6.2 6.0
Hispanic or Latina 5 . . . . . . . . . . . . . . . -- -- -- -- 6.1 5.9 5.5 5.6 5.4
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 5.7 5.4 5.1 5.3 5.0
Black or African American . . . . . . . . . . -- -- -- -- 12.6 12.2 10.6 10.7 10.6
* Estimates are considered unreliable. Rates preceded by an asterisk are based on fewer than 50 deaths in the numerator. Rates not shown are based on fewer than 20
deaths in the numerator.
- - - Data not available.
1
Rates based on unweighted birth cohort data.
2
Rates based on a period file using weighted data. See Appendix I, National Vital Statistics System (NVSS), Linked Birth/Infant Death Data Set.
3
Infant (under 1 year of age), neonatal (under 28 days), and postneonatal (28 days11 months).
4
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
See Appendix II, Race.
5
Persons of Hispanic origin may be of any race.
6
Prior to 1995, data are shown only for states with an Hispanic-origin item on their birth certificates. See Appendix II, Hispanic origin.
7
Rates for 19992004 (shown in spreadsheet version) exclude data from Oklahoma, which did not report Hispanic origin on the fetal death report in those years.
8
Starting with 2014 data, the obstetric estimate of gestation at delivery replaced the gestational age measure based on the date of the last normal menses, which was
used for prior years. For more information on the impact of this change, see Appendix l, National Vital Statistic System (NVSS).
9
Number of fetal deaths of 20 weeks or more gestation per 1,000 live births plus fetal deaths.
10
Number of fetal deaths of 28 weeks or more gestation (late fetal deaths) per 1,000 live births plus late fetal deaths.
11
Number of late fetal deaths plus infant deaths within 7 days of birth per 1,000 live births plus late fetal deaths.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander include persons of Hispanic and non-Hispanic origin. Starting
with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. National linked files do not exist for 19921994. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Linked Birth/Infant Death Data Set, public-use Fetal Death File, public-use Birth File. National Center for
Health Statistics. Mathews TJ, Driscoll AK. Trends in infant mortality in the United States, 20052014. NCHS data brief, no 279. Hyattsville, MD: NCHS; 2017. Available
from: https://www.cdc.gov/nchs/products/databriefs.htm and National Center for Health Statistics. 2014 fetal death data set and user's guide. Hyattsville, MD: 2016.
Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. See Appendix I, National Vital Statistics System (NVSS).
Neonatal 1
Under Under
Race and year Infant 1 28 days 7 days Postneonatal 1
1
Infant (under 1 year of age), neonatal (under 28 days), early neonatal (under 7 days), and postneonatal (28 days11 months).
2
Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.
3
Infant deaths and live births are tabulated by race of infant. See Appendix II, Race.
4
Infant deaths are tabulated by race of infant; live births are tabulated by race of mother. See Appendix II, Race.
NOTES: Infant mortality rates in this table are based on infant deaths from the mortality file (numerator) and live births from the natality file (denominator).
Inconsistencies in reporting race for the same infant between the birth and death certificate can result in underestimated infant mortality rates for races other than
white or black. Infant mortality rates for additional population groups are available from the Linked Birth/Infant Death Data Set and are presented in Table 10. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System, public-use Mortality File, public-use Birth File; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data
for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital
* Estimates are considered unreliable. Rates preceded by an asterisk are based on fewer than 50 deaths in the numerator. Rates not shown are based on fewer than 20
deaths in the numerator.
- - - Data not available.
1
Rates based on unweighted birth cohort data.
2
Rates based on period file using weighted data. See Appendix I, National Vital Statistics System (NVSS), Linked Birth/Infant Death Data Set.
3
Under 1 year of age.
4
Excludes data for American Samoa, Guam, Northern Marianas, Puerto Rico, and Virgin Islands.
5
Rates for white and black are substituted for non-Hispanic white and non-Hispanic black for Louisiana for 1989, Oklahoma for 19891990, and New Hampshire for
19891991.
6
Comparable data were not available for all time periods and for all racial and ethnicity groups. Therefore, only selected rates are presented for the territories. Linked
birth/infant death data are not available for American Samoa and Northern Marianas.
7
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
8
Includes persons of Hispanic origin.
9
Rates for Hispanic origin exclude data from states not reporting Hispanic origin on the birth certificate for 1 or more years in a 3-year period.
NOTES: Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. National linked files do not exist for 19921994.
SOURCE: NCHS, National Vital Statistics System, public-use and nonpublic-use Linked Birth/Infant Death Data Set. National Center for Health Statistics. Mathews TJ,
Driscoll AK. Trends in infant mortality in the United States, 2005-2014. NCHS data brief, no 279. Hyattsville, MD: NCHS; 2017. Available from: https://www.cdc.gov/
nchs/products/databriefs.htm. See Appendix I, National Vital Statistics System (NVSS).
International rankings 1
Country 2 1960 1970 1980 1990 2000 2010 2012 2013 1960 2013
Break in series. See OECD website for additional information. Available from: http://www.oecd.org/.
1
Rankings are from lowest to highest infant mortality rates (IMR). Countries with the same IMR receive the same rank. The country with the next highest IMR is assigned
the rank it would have received had the lower-ranked countries not been tied, i.e., skip a rank. The latest year's international rankings are based on 2013 data because
that is the most current data year for which most countries have reported their final data to OECD. Countries without an estimate in the OECD database are omitted
from ranking. Relative rankings for individual countries may be affected if not all countries have reported data to OECD.
2
Refers to countries, territories, cities, or geographic areas with at least 2.5 million population in 2000 (United Nations, Department of Economic and Social Affairs,
Population Division. World Urbanization Prospects: The 2014 Revision, Volume I: Comprehensive Tables. ST/ESA/SER.A/379. 2015. Available from:
https://esa.un.org/unpd/wpp/Publications/Files/WPP2015_Volume-I_Comprehensive-Tables.pdf) and with complete counts of live births and infant deaths according to
the United Nations Demographic Yearbook.
3
The infant mortality rate is defined as the number of deaths of children under one year of age, expressed per 1,000 live births. Some of the international variation in
infant mortality rates is due to variations among countries in registering practices for premature infants. See OECD website for additional information. Available at:
http://www.oecd.org/.
4
In 1993, Czechoslovakia was divided into two nations, the Czech Republic and Slovakia. Data for years prior to 1993 are from the Czech and Slovak regions of
Czechoslovakia.
5
Until 1990, estimates refer to the Federal Republic of Germany; from 1995 onward data refer to Germany after reunification.
6
Statistical data for Israel are supplied by, and under the responsibility of, the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the
status of the Golan Heights, East Jerusalem, and Israeli settlements in the West Bank under the terms of international law.
NOTE: Some rates for selected countries and selected years were revised and differ from previous editions of Health, United States.
SOURCE: Organisation for Economic Co-operation and Development (OECD) Health Data 2016, incorporating revisions to the annual update, accessed on February 2,
2017. Available from: http://www.oecd.org/. See Appendix I, Organisation for Economic Co-operation and Development (OECD) Health Data.
Male Female
Country 1980 1990 2000 2013 2014 1980 1990 2000 2013 2014
Male Female
Country 1980 1990 2000 2013 2014 1980 1990 2000 2013 2014
Data are estimated. See OECD website for updated data and additional information. Available at: http://www.oecd.org/.
Break in series. See OECD website for updated data and additional information. Available at: http://www.oecd.org/.
1
In 1993, Czechoslovakia was divided into two nations, the Czech Republic and Slovakia. Data for years prior to 1993 are from the Czech and Slovak regions of
Czechoslovakia.
2
Until 1990, estimates refer to the Federal Republic of Germany; from 1995 onward data refer to Germany after reunification.
3
Statistical data for Israel are supplied by, and under the responsibility of, the relevant Israeli authorities. The use of such data by OECD is without prejudice to the
status of the Golan Heights, East Jerusalem, and Israeli settlements in the West Bank under the terms of international law.
NOTES: Differences in life expectancy may reflect differences in reporting and calculation methods, which can vary by country, in addition to actual differences in
mortality rates. Therefore, ranks are not presented and comparisons among countries should be made with caution. See Appendix II, Life expectancy. Some estimates
for selected countries and selected years were revised and differ from previous editions of Health, United States.
SOURCE: Organisation for Economic Co-operation and Development (OECD) Health Data 2016, OECD. StatExtracts, accessed on February 2, 2017. Available from:
http://www.oecd.org/; NCHS. Vital statistics of the United States (selected years). Public Health Service. Washington, DC. See Appendix I, Organisation for Economic
Co-operation and Development (OECD) Health Data.
2
Death registration area only. The death registration area increased from 10 states and the District of Columbia (D.C.) in 1900 to the coterminous United States in 1933.
3
Includes deaths of persons who were not residents of the 50 states and D.C.
4
Life expectancy estimates for 2013 are based on final Medicare data. Life expectancy estimates for 2014 and 2015 are based on preliminary Medicare data.
5
Hispanic origin was added to the U.S. standard death certificate in 1989 and was adopted by every state in 1997. Life expectancies for the Hispanic population are
adjusted for underreporting on the death certificate of Hispanic ethnicity, but are not adjusted to account for the potential effects of return migration. To address the
effects of age misstatement at the oldest ages, the probability of death for Hispanic persons older than 80 years is estimated as a function of non-Hispanic white
mortality with the use of the Brass relational logit model. See Appendix II, Hispanic origin. See Appendix II, Race, for a discussion of sources of bias in death rates by
race and Hispanic origin.
6
Tables by Hispanic origin are adjusted for race and Hispanic origin misclassification with classification ratios. Life expectancy estimates for 20102015 use the 2016
classification ratios. See NOTES section of this table.
NOTES: Populations for computing life expectancy for 19911999 are 1990-based postcensal estimates of the U.S. resident population. Starting with Health, United
States, 2012, populations for computing life expectancy for 20012009 were based on revised intercensal population estimates of the U.S. resident population.
Populations for computing life expectancy for 2010 were based on 2010 census counts. Life expectancy for 2011 and beyond was computed using 2010-based
postcensal estimates. See Appendix I, Population Census and Population Estimates. In 1997, life table methodology was revised to construct complete life tables by
single years of age that extend to age 100. (Anderson RN. Method for constructing complete annual U.S. life tables. NCHS. Vital Health Stat 2(129). 1999.) Previously,
abridged life tables were constructed for 5-year age groups ending with 85 years and over. In 2000, the life table methodology was revised. The revised methodology is
similar to that developed for the 19992001 decennial life tables. In 2008, the life table methodology was further refined. Estimates for 2001 and onwards were revised
based on the methodology used in the 2008 life table report. Life expectancy for 20012015, except as noted in footnote 4, was calculated using data from Medicare
to supplement vital statistics and census data. Starting with Health, United States, 2016, life expectancy for 20102015 were revised to take into account updated race
and Hispanic origin classification ratios. See Arias E, Heron M, Hakes JK. The validity of race and Hispanic origin reporting on death certificates in the United States: An
update. NCHS. Vital Health Stat 2(172). 2016. Available from: http://www.cdc.gov/nchs/data/series/sr_02/sr02_172.pdf. See Appendix II, Life expectancy. Starting with
2003 data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race
categories of the 1977 Office of Management and Budget standards, for comparability with other states. The race groups, white and black include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Some data were revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System, public-use Mortality Files; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington,
DC: U.S. Government Printing Office, 1968; Arias E. United States life tables by Hispanic origin. Vital health statistics; vol 2 no 152. Hyattsville, MD: NCHS. 2010; United
States Life Tables, 20012009 (using revised intercensal population estimates and a new methodology implemented with the final 2008 life tables); United States Life
Tables, 20102012 (using a new methodology implemented with the final 2008 life tables and updated race and Hispanic origin classification ratios); United States Life
Tables, 2013, forthcoming (using a new methodology implemented with the final 2008 life tables and updated race and Hispanic origin classification ratios). Life table
reports available from: http://www.cdc.gov/nchs/products/life_tables.htm; (for 2014 life expectancy) Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United
States, 2015. NCHS data brief, no 267. Hyattsville, MD: NCHS; 2016. Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics
reports. Hyattsville, MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm; unpublished 2015 life expectancy estimates for white and black
persons at birth, at age 65, and at age 75. See Appendix I, National Vital Statistics System (NVSS).
American
Black or Indian or Asian or White,
African Alaska Pacific Hispanic not Hispanic
All persons White American Native 1 Islander 1 or Latino 1 or Latino 1
State and territory 19791981 19891991 20132015 20132015 20132015 20132015 20132015 20132015 20132015
Rate shown is for 20102012 because death data were not available for the Virgin Islands for 2013 and 2014.
* Prior to 20092011 (shown in spreadsheet file), data for states with populations under 10,000 in the middle year of a 3-year period, or fewer than 50 deaths for the
3-year period, are considered unreliable and are not shown. Starting with 20092011 estimates (shown in spreadsheet file), data for states with an average population
for the 3-year period of under 10,000, or fewer than 50 deaths for the 3-year period, are considered unreliable and are not shown.
1
Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with caution because of inconsistencies
in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate denominators). The net effect of
misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a detailed discussion of sources of
bias in death rates by race and Hispanic origin.
2
Age-adjusted average annual death rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard
million proportions based on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. Age-
adjusted rates for Puerto Rico, Virgin Islands, Guam, American Samoa, and Northern Marianas were computed by applying the age-specific death rates to the U.S.
standard population combining the age groups for age 75 and over. For the territories, age groups were not available for those age 75 and over by age. See Appendix
II, Age adjustment. Prior to 20092011 (shown in spreadsheet file), denominators for rates are resident population estimates for the middle year of each 3-year period,
multiplied by 3. Starting with 20092011 estimates (shown in spreadsheet file), denominators for rates are the 3-year average population. See Appendix I, Population
Census and Population Estimates.
3
Excludes data for American Samoa, Guam, Northern Marianas, Puerto Rico, and Virgin Islands.
4
Comparable population data were not available for all time periods and for all racial and ethnicity groups. Therefore, only selected rates are presented for the territories.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. United States, state, and territory rates for 2011 and beyond were calculated using 2010-based postcensal population estimates.
Starting with 2003 data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget
(OMB) standards. The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states.
See Appendix II, Race. Rates are rounded at the end of the calculation process. They may differ from rates based on the same data presented elsewhere if rounding is
done earlier in the calculation process. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; numerator data from annual public-use and nonpublic-use Mortality Files; denominator data from state population
estimates prepared by the U.S. Census Bureau 1980 from April 1, 1980 MARS Census File; 1990 from April 1, 1990 MARS Census File; 2011 and beyond from
2010-based postcensal bridged-race files. Available from: http://www.cdc.gov/nchs/nvss/bridged_race.htm. For the territories (except for Puerto Rico) populations are
from the U.S. Census Bureau. International data base. 2010. Available from: http://www.census.gov/population/international/. For Puerto Rico, populations are from
U.S. Census Bureau. Puerto Rico Commonwealth characteristics. See Appendix I, National Vital Statistics System (NVSS).
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2014 4 2015 4
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2014 4 2015 4
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2014 4 2015 4
Data for Alzheimer's disease are only presented for data years 1999 and beyond due to large differences in death rates caused by changes in the International
Classification of Diseases (ICD) coding of the causes of death between ICD9 and ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
. . . Category not applicable.
1
Underlying cause of death code numbers are based on the applicable revision of the ICD for data years shown. See Appendix II, Cause of death; Table III; Table IV.
2
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
3
Underlying cause of death was coded according to the 6th Revision of the ICD in 1950, 7th Revision in 1960, 8th Revision in 1970, and 9th Revision in 19801998. See
Appendix II, Cause of death; Table III; Table IV.
4
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
5
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
6
Between 1998 and 1999, the cause of death title for Chronic obstructive pulmonary diseases in the ICD9 was renamed to Chronic lower respiratory diseases (CLRD)
in ICD10.
7
Starting with 1999 data, the rules for selecting CLRD and Pneumonia as the underlying cause of death changed, resulting in an increase in the number of deaths
for CLRD and a decrease in the number of deaths for pneumonia. Therefore, trend data for these two causes of death should be interpreted with caution. For more
information, see Comparability of cause of death between the 9th and 10th revisions of the International Classification of Diseases in Appendix II, Table V.
8
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome, and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome, and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
Notes in Deaths: Final data for 2011, available from: http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_03.pdf.
9
Figures for 2001 (in Excel spreadsheet on the Web) include September 11-related deaths for which death certificates were filed as of October 24, 2002. See Appendix
II, Cause of death; Table IV for terrorism-related ICD10 codes.
10
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
11
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Starting with 2003 data, some states began
to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The multiple-race data
for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Some data have been revised and differ from
previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
Crude Age-adjusted 1
Sex, race, Hispanic origin, and cause of death 2 2015 3 1980 2 1990 2 2000 3 2010 3 2014 3 2015 3
All persons Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 7,214.0 10,448.4 9,085.5 7,578.1 6,642.9 6,622.1 6,757.7
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 1,090.7 2,238.7 1,617.7 1,253.0 972.4 952.0 956.6
Ischemic heart disease . . . . . . . . . . . . . . . . 622.5 1,729.3 1,153.6 841.8 577.3 537.1 530.3
Cerebrovascular diseases . . . . . . . . . . . . . . . . 183.0 357.5 259.6 223.3 169.3 160.1 161.0
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,501.2 2,108.8 2,003.8 1,674.1 1,395.8 1,310.4 1,283.3
Trachea, bronchus, and lung . . . . . . . . . . . . 342.1 548.5 561.4 443.1 331.3 287.7 273.4
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 140.6 190.0 164.7 141.9 125.0 122.2 123.3
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 59.1 84.9 96.8 63.6 52.2 47.6 46.7
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 272.0 463.2 451.6 332.6 262.4 245.9 241.9
Chronic lower respiratory diseases . . . . . . . . . . 217.1 169.1 187.4 188.1 172.4 174.1 175.9
Influenza and pneumonia . . . . . . . . . . . . . . . . 81.7 160.2 141.5 87.1 71.4 93.3 74.2
Chronic liver disease and cirrhosis. . . . . . . . . . . 205.9 300.3 196.9 164.1 163.9 180.7 190.3
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 200.8 134.4 155.9 178.4 158.2 170.8 176.2
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 17.1
10.9 11.7 11.4 13.0
Human immunodeficiency virus (HIV) disease . . . . 50.2 ... 383.8 174.6 76.6 55.0 50.4
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,139.2 1,543.5 1,162.1 1,026.5 1,025.2 1,080.1 1,172.0
Motor vehicle-related injuries . . . . . . . . . . . . 394.4 912.9 716.4 574.3 400.6 383.0 404.9
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 510.4 68.0 81.2 163.6 379.7 465.8 531.2
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 79.6 -- 50.4 70.7 73.1 66.7 69.3
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 418.7 392.0 393.1 334.5 385.2 413.6 428.6
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 241.8 425.5 417.4 266.5 239.0 224.5 251.9
Male
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 8,960.1 13,777.2 11,973.5 9,572.2 8,329.5 8,276.4 8,474.7
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 1,482.8 3,352.1 2,356.0 1,766.0 1,370.8 1,326.9 1,327.6
Ischemic heart disease . . . . . . . . . . . . . . . . 895.4 2,715.1 1,766.3 1,255.4 864.8 797.6 784.1
Cerebrovascular diseases . . . . . . . . . . . . . . . . 204.3 396.7 286.6 244.6 190.7 184.9 183.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,583.8 2,360.8 2,214.6 1,810.8 1,500.8 1,396.9 1,365.3
Trachea, bronchus, and lung . . . . . . . . . . . . 385.2 821.1 764.8 554.9 390.5 331.8 315.8
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 161.7 214.9 194.3 167.3 148.0 144.3 144.2
Prostate . . . . . . . . . . . . . . . . . . . . . . . . . 59.1 84.9 96.8 63.6 52.2 47.6 46.7
Chronic lower respiratory diseases . . . . . . . . . . 221.5 235.1 224.8 206.0 182.8 182.8 184.5
Influenza and pneumonia . . . . . . . . . . . . . . . . 92.9 202.5 180.0 102.8 82.6 103.7 85.6
Chronic liver disease and cirrhosis. . . . . . . . . . . 270.8 415.0 283.9 236.9 226.9 242.6 252.5
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 245.9 140.4 170.4 203.8 194.8 214.0 220.7
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 14.7
10.6 10.7 10.3 11.7
Human immunodeficiency virus (HIV) disease . . . . 72.8 ... 686.2 258.9 109.5 79.0 72.7
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,608.3 2,342.7 1,715.1 1,475.6 1,432.1 1,509.6 1,642.4
Motor vehicle-related injuries . . . . . . . . . . . . 571.5 1,359.7 1,018.4 796.4 569.2 550.4 579.7
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 697.2 96.4 123.6 242.1 503.8 623.8 722.2
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 90.7 -- 58.9 81.1 82.3 78.6 80.3
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 643.4 605.6 634.8 539.1 607.0 635.1 654.2
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 397.5 675.0 658.0 410.5 380.3 357.3 407.0
Female
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 5,481.1 7,350.3 6,333.1 5,644.6 4,994.0 4,999.8 5,070.7
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 701.5 1,246.0 948.5 774.6 593.6 595.2 603.4
Ischemic heart disease . . . . . . . . . . . . . . . . 351.6 852.1 600.3 457.6 305.2 290.2 289.7
Cerebrovascular diseases . . . . . . . . . . . . . . . . 161.8 324.0 235.9 203.9 149.1 136.5 140.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,419.2 1,896.8 1,826.6 1,555.3 1,301.0 1,232.6 1,209.8
Trachea, bronchus, and lung . . . . . . . . . . . . 299.3 310.4 382.2 342.1 276.9 247.1 234.4
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 119.6 168.7 138.7 118.7 103.4 101.4 103.6
Breast . . . . . . . . . . . . . . . . . . . . . . . . . . 272.0 463.2 451.6 332.6 262.4 245.9 241.9
Chronic lower respiratory diseases . . . . . . . . . . 212.8 114.0 155.9 172.3 162.8 166.1 167.9
Influenza and pneumonia . . . . . . . . . . . . . . . . 70.7 122.0 106.2 72.3 60.7 83.4 63.1
Chronic liver disease and cirrhosis. . . . . . . . . . . 141.6 194.5 115.1 94.5 103.5 121.5 130.6
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 156.0 128.5 142.3 154.4 123.5 129.6 133.8
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 19.5
11.1 12.6 12.5 14.1
Human immunodeficiency virus (HIV) disease . . . . 27.8 ... 87.8 92.0 44.4 31.6 28.7
Unintentional injuries . . . . . . . . . . . . . . . . . . . 673.6 755.3 607.4 573.2 616.4 647.5 698.3
Motor vehicle-related injuries . . . . . . . . . . . . 218.7 470.4 411.6 348.5 230.5 213.6 228.1
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 325.0 40.2 39.1 85.0 255.1 306.6 338.9
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 68.7 -- 42.4 60.8 64.6 55.3 58.8
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 195.7 184.2 153.3 129.1 163.7 191.2 201.7
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 87.3 181.3 174.3 118.9 94.9 88.7 93.1
See footnotes at end of table.
Crude Age-adjusted 1
Sex, race, Hispanic origin, and cause of death 2 2015 3 1980 2 1990 2 2000 3 2010 3 2014 3 2015 3
White 8 Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 7,090.6 9,554.1 8,159.5 6,949.5 6,342.8 6,390.1 6,514.8
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 1,056.0 2,100.8 1,490.3 1,149.4 900.9 883.0 889.0
Ischemic heart disease . . . . . . . . . . . . . . . . 635.4 1,682.7 1,113.4 805.3 563.7 524.8 519.2
Cerebrovascular diseases . . . . . . . . . . . . . . . . 163.3 300.7 213.1 187.1 142.7 138.1 137.9
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,549.3 2,035.9 1,929.3 1,627.8 1,375.8 1,301.5 1,274.9
Trachea, bronchus, and lung . . . . . . . . . . . . 365.1 529.9 544.2 436.3 332.8 291.0 277.8
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 140.7 186.8 157.8 134.1 118.4 117.6 119.3
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 55.2 74.8 86.6 54.3 45.3 41.8 40.9
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 263.7 460.2 441.7 315.6 245.0 230.3 226.7
Chronic lower respiratory diseases . . . . . . . . . . 236.7 165.4 182.3 185.3 176.1 178.7 180.1
Influenza and pneumonia . . . . . . . . . . . . . . . . 79.6 130.8 116.9 77.7 66.7 90.1 70.2
Chronic liver disease and cirrhosis. . . . . . . . . . . 228.2 257.3 175.8 162.7 173.5 195.1 206.3
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 186.5 115.7 133.7 155.6 139.0 152.6 157.5
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 19.2
11.4 12.4 12.0 13.6
Human immunodeficiency virus (HIV) disease . . . . 27.6 ... 309.0 94.7 39.9 30.2 27.3
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,208.7 1,520.4 1,139.7 1,031.8 1,098.6 1,156.4 1,258.9
Motor vehicle-related injuries . . . . . . . . . . . . 398.5 939.9 726.7 586.1 419.0 395.9 415.4
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 578.7 64.9 74.4 167.2 435.4 534.7 610.6
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 66.5 -- 37.0 52.5 57.4 53.6 55.2
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 469.3 414.5 417.7 362.0 430.8 468.3 484.7
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 127.3 271.7 234.9 156.6 138.7 125.7 135.9
Black or African American 8
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 9,764.6 17,873.4 16,593.0 12,897.1 9,832.5 9,490.6 9,702.3
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 1,613.8 3,619.9 2,891.8 2,275.2 1,691.1 1,638.9 1,637.9
Ischemic heart disease . . . . . . . . . . . . . . . . 737.4 2,305.1 1,676.1 1,300.1 818.8 756.5 740.4
Cerebrovascular diseases . . . . . . . . . . . . . . . . 318.0 883.2 656.4 507.0 358.1 322.3 322.9
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,610.4 2,946.1 2,894.8 2,294.7 1,796.7 1,651.6 1,598.8
Trachea, bronchus, and lung . . . . . . . . . . . . 328.8 776.0 811.3 593.0 405.6 340.8 318.3
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 171.3 232.3 241.8 222.4 188.6 176.5 172.9
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 102.4 200.3 223.5 171.0 127.3 109.0 106.9
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 378.6 524.2 592.9 500.0 420.8 386.7 379.2
Chronic lower respiratory diseases . . . . . . . . . . 201.7 203.7 240.6 232.7 187.7 193.6 198.3
Influenza and pneumonia . . . . . . . . . . . . . . . . 114.9 384.9 330.8 161.2 109.8 130.9 114.5
Chronic liver disease and cirrhosis. . . . . . . . . . . 121.6 644.0 371.8 185.6 120.2 120.4 122.5
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 325.5 305.3 361.5 383.4 316.4 321.4 329.6
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 12.6
8.3 10.0 11.2 13.0
Human immunodeficiency virus (HIV) disease . . . . 192.4 ... 1,014.7 763.3 329.5 222.9 203.5
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,081.0 1,751.5 1,392.7 1,152.8 896.7 986.8 1,082.6
Motor vehicle-related injuries . . . . . . . . . . . . 457.4 750.2 699.5 580.8 393.4 404.6 450.7
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 326.8 99.4 144.3 196.6 218.9 289.7 342.1
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 172.9 -- 160.9 216.9 193.2 167.1 174.6
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 218.5 238.0 261.4 208.7 196.4 209.0 216.1
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 942.0 1,580.8 1,612.9 941.6 821.2 785.1 907.4
American Indian or
Alaska Native 8
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 6,895.3 13,390.9 9,506.2 7,758.2 6,771.3 6,954.0 7,176.2
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 770.5 1,819.9 1,391.0 1,030.1 820.6 822.2 850.0
Ischemic heart disease . . . . . . . . . . . . . . . . 437.5 1,208.2 901.8 709.3 487.6 492.0 487.5
Cerebrovascular diseases . . . . . . . . . . . . . . . . 124.3 269.3 223.3 198.1 129.7 123.2 138.6
Malignant neoplasms . . . . . . . . . . . . . . . . . . 776.0 1,101.3 1,141.1 995.7 929.5 809.9 848.8
Trachea, bronchus, and lung . . . . . . . . . . . . 148.5 181.1 268.1 227.8 211.0 168.4 166.0
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 84.1 78.8 82.4 93.8 95.8 90.2 94.5
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 28.3 66.7 42.0 44.5 36.8 39.0 32.6
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 119.1 205.5 213.4 174.1 145.0 110.9 129.7
Chronic lower respiratory diseases . . . . . . . . . . 147.0 89.3 129.0 151.8 154.5 140.5 158.2
Influenza and pneumonia . . . . . . . . . . . . . . . . 69.5 307.9 206.3 124.0 99.3 129.0 75.5
Chronic liver disease and cirrhosis. . . . . . . . . . . 543.8 1,190.3 535.1 519.4 510.8 549.9 605.3
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 269.5 305.5 292.3 305.6 267.6 279.4 300.7
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 4.3
* 8.8 6.7 5.3
Human immunodeficiency virus (HIV) disease . . . . 33.2 ... 70.1 68.4 46.1 29.5 36.2
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,512.5 3,541.0 2,183.9 1,700.1 1,377.7 1,509.3 1,523.6
Motor vehicle-related injuries . . . . . . . . . . . . 652.8 2,102.4 1,301.5 1,032.2 570.6 605.4 638.0
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 516.1 92.9 119.5 180.1 449.6 537.8 543.5
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 67.2 -- 88.5 102.0 81.7 80.5 74.1
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 513.0 515.0 495.9 403.1 437.9 437.1 497.7
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 263.2 628.9 434.2 278.5 256.4 239.0 256.2
See footnotes at end of table.
Crude Age-adjusted 1
Sex, race, Hispanic origin, and cause of death 2 2015 3 1980 2 1990 2 2000 3 2010 3 2014 3 2015 3
Asian or Pacific Islander 8 Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 3,073.6 5,378.4 4,705.2 3,811.1 3,061.2 2,954.4 3,049.7
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 414.8 952.8 702.2 567.9 400.1 402.1 400.6
Ischemic heart disease . . . . . . . . . . . . . . . . 249.9 697.7 486.6 381.1 250.6 239.8 240.1
Cerebrovascular diseases . . . . . . . . . . . . . . . . 133.8 266.9 233.5 199.4 148.3 121.8 129.5
Malignant neoplasms . . . . . . . . . . . . . . . . . . 839.1 1,218.6 1,166.4 1,033.8 874.7 799.4 809.9
Trachea, bronchus, and lung . . . . . . . . . . . . 137.1 238.2 204.7 185.8 148.2 136.5 130.5
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 84.0 115.9 105.1 91.6 87.6 79.1 80.8
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 18.6 17.0 32.4 18.8 17.0 16.8 18.6
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 165.6 222.2 216.5 200.8 156.9 160.6 155.1
Chronic lower respiratory diseases . . . . . . . . . . 29.1 56.4 72.8 56.5 33.2 32.7 28.0
Influenza and pneumonia . . . . . . . . . . . . . . . . 36.5 79.3 74.0 48.6 38.4 42.8 36.1
Chronic liver disease and cirrhosis. . . . . . . . . . . 45.5 85.6 72.4 44.8 41.7 41.6 44.0
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 78.9 83.1 74.0 77.0 69.5 73.8 75.4
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 4.4
3.5 3.2 2.6 4.3
Human immunodeficiency virus (HIV) disease . . . . 11.2 ... 77.0 19.9 10.7 9.8 11.0
Unintentional injuries . . . . . . . . . . . . . . . . . . . 336.8 742.7 636.6 425.7 303.0 307.0 328.6
Motor vehicle-related injuries . . . . . . . . . . . . 144.3 472.6 445.5 263.4 147.9 141.2 140.4
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 89.6 * 17.6 25.9 46.5 67.6 84.3
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 33.6 --- 26.7 33.6 38.1 29.1 32.3
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 229.9 217.1 200.6 168.6 199.7 203.1 222.0
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 61.5 201.1 205.8 113.1 68.8 59.7 60.6
Hispanic or Latino 8,9
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 4,452.8 --- 7,963.3 6,037.6 4,795.1 4,676.8 4,750.4
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 474.5 --- 1,082.0 821.3 598.1 567.9 578.0
Ischemic heart disease . . . . . . . . . . . . . . . . 268.9 --- 756.6 564.6 366.6 334.1 339.9
Cerebrovascular diseases . . . . . . . . . . . . . . . . 116.9 --- 238.0 207.8 150.4 140.2 141.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . 752.0 --- 1,232.2 1,098.2 951.2 909.3 900.6
Trachea, bronchus, and lung . . . . . . . . . . . . 74.6 --- 193.7 152.1 115.0 96.8 96.9
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 75.5 --- 100.2 101.4 94.0 87.4 92.4
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 26.0 --- 47.7 42.9 38.2 36.5 37.8
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 143.0 --- 299.3 230.7 180.0 183.4 169.0
Chronic lower respiratory diseases . . . . . . . . . . 44.3 --- 78.8 68.5 59.6 52.7 54.3
Influenza and pneumonia . . . . . . . . . . . . . . . . 47.9 --- 130.1 76.0 57.5 79.1 54.3
Chronic liver disease and cirrhosis. . . . . . . . . . . 182.7 --- 329.1 252.1 201.6 216.4 219.2
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 130.9 --- 177.8 215.6 158.5 160.9 163.1
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 6.8 ---
6.9 8.4 8.9 10.2
Human immunodeficiency virus (HIV) disease . . . . 41.6 ... 600.1 209.4 74.9 49.5 47.0
Unintentional injuries . . . . . . . . . . . . . . . . . . . 827.8 --- 1,190.6 920.1 708.7 740.1 808.7
Motor vehicle-related injuries . . . . . . . . . . . . 392.1 --- 740.8 540.2 340.3 348.3 370.7
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 263.2 --- 121.9 145.9 191.2 234.1 269.1
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 49.0 --- 54.4 62.0 67.7 56.3 60.1
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 221.6 --- 256.2 188.5 193.6 214.3 215.4
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 229.1 --- 720.8 335.1 238.0 197.6 213.5
White, not Hispanic or Latino 9
All causes . . . . . . . . . . . . . . . . . . . . . . . . . 7,661.5 --- 8,022.5 6,960.5 6,545.3 6,659.4 6,799.9
Diseases of heart . . . . . . . . . . . . . . . . . . . . . 1,193.0 --- 1,504.0 1,175.1 943.2 932.4 939.2
Ischemic heart disease . . . . . . . . . . . . . . . . 721.6 --- 1,127.2 824.7 590.8 553.6 546.4
Cerebrovascular diseases . . . . . . . . . . . . . . . . 172.0 --- 210.1 183.0 139.1 134.9 134.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,737.4 --- 1,974.1 1,668.4 1,421.5 1,349.1 1,320.0
Trachea, bronchus, and lung . . . . . . . . . . . . 439.1 --- 566.8 460.3 359.1 318.6 304.0
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . 155.7 --- 162.1 136.2 121.2 122.3 123.0
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . 62.4 --- 89.2 54.9 45.9 42.2 41.0
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . 291.1 --- 451.5 322.3 252.6 235.4 234.1
Chronic lower respiratory diseases . . . . . . . . . . 285.4 --- 188.1 193.8 189.1 195.9 197.1
Influenza and pneumonia . . . . . . . . . . . . . . . . 86.3 --- 112.3 76.4 67.8 91.1 72.3
Chronic liver disease and cirrhosis. . . . . . . . . . . 234.4 --- 162.4 150.9 166.9 188.6 200.7
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . 197.1 --- 131.2 150.2 136.7 150.6 156.2
Alzheimer's disease . . . . . . . . . . . . . . . . . . . 22.2 ---
11.7 12.7 12.3 13.8
Human immunodeficiency virus (HIV) disease . . . . 22.4 ... 271.2 76.0 31.3 24.7 21.1
Unintentional injuries . . . . . . . . . . . . . . . . . . . 1,285.9 --- 1,114.7 1,041.4 1,183.0 1,253.8 1,365.1
Motor vehicle-related injuries . . . . . . . . . . . . 390.8 --- 715.7 588.8 430.6 398.9 417.6
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . 652.3 --- 68.3 169.4 494.0 613.2 700.8
Nephritis, nephrotic syndrome, and nephrosis 6 . . . 69.8 --- 34.5 51.1 55.3 52.7 53.7
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . 529.2 --- 433.0 389.2 483.8 531.3 554.1
Homicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . 96.1 --- 162.0 113.2 103.4 98.4 106.2
See footnotes at end of table.
Data for Alzheimer's disease are only presented for data years 1999 and beyond due to large differences in death rates caused by changes in the coding of this cause
of death between ICD9 and ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
2
Underlying cause of death was coded according to the 9th Revision of the International Classification of Diseases (ICD) in 19801998. See Appendix II, Cause of
death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Rate for male population only.
5
Rate for female population only.
6
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome, and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome, and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
7
Figures for 2001 (in Excel spreadsheet on the Web) include September 11-related deaths for which death certificates were filed as of October 24, 2002. See Appendix
II, Cause of death; Table IV for terrorism-related ICD10 codes.
8
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
9
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. See Appendix II, Years of potential life lost (YPLL)
for definition and method of calculation. Starting with 2003 data, some states began to collect information on more than one race on the death certificate, according
to 1997 Office of Management and Budget (OMB) standards. The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB
standards, for comparability with other states. See Appendix II, Race. Rates are rounded at the end of the calculation process. They may differ from rates based on the
same data presented elsewhere if rounding is done earlier in the calculation process. Data for additional years are available. See the Excel spreadsheet on the Health,
United States website at: http://www.cdc.gov/nchs/hus.htm. Some data have been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System; numerator data from annual public-use Mortality Files; denominator data from national population estimates for race
groups from Table 1 and unpublished Hispanic population estimates for 19901996 prepared by the Housing and Household Economic Statistics Division, U.S. Census
Bureau. See Appendix I, National Vital Statistics System (NVSS).
All persons
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . 1,989,841 All causes . . . . . . . . . . . . . . . . . . . . . . . 2,712,630
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . 761,085 Diseases of heart . . . . . . . . . . . . . . . . . . 633,842
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . 416,509 Malignant neoplasms . . . . . . . . . . . . . . . . 595,930
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 170,225 Chronic lower respiratory diseases 1,2 . . . . . . 155,041
4 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . 105,718 Unintentional injuries . . . . . . . . . . . . . . . . 146,571
5 . . . . . . . . . . Chronic obstructive pulmonary diseases 1 . . . . . . . 56,050 Cerebrovascular diseases . . . . . . . . . . . . . 140,323
6 . . . . . . . . . . Pneumonia and influenza 2 . . . . . . . . . . . . . . . . 54,619 Alzheimer's disease . . . . . . . . . . . . . . . . . 110,561
7 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . 34,851 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . 79,535
8 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . . 30,583 Influenza and pneumonia 2 . . . . . . . . . . . . . 57,062
9 . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . 29,449 Nephritis, nephrotic syndrome, and nephrosis 3 49,959
10 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,869 Suicide . . . . . . . . . . . . . . . . . . . . . . . . 44,193
Male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . 1,075,078 All causes . . . . . . . . . . . . . . . . . . . . . . . 1,373,404
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . 405,661 Diseases of heart . . . . . . . . . . . . . . . . . . 335,002
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . 225,948 Malignant neoplasms . . . . . . . . . . . . . . . . 313,818
3 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . 74,180 Unintentional injuries . . . . . . . . . . . . . . . . 92,919
4 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 69,973 Chronic lower respiratory diseases 1,2 . . . . . . 72,498
5 . . . . . . . . . . Chronic obstructive pulmonary diseases 1 . . . . . . . 38,625 Cerebrovascular diseases . . . . . . . . . . . . . 58,288
6 . . . . . . . . . . Pneumonia and influenza 2 . . . . . . . . . . . . . . . . 27,574 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . 43,123
7 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,505 Suicide . . . . . . . . . . . . . . . . . . . . . . . . 33,994
8 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . . 19,768 Alzheimer's disease . . . . . . . . . . . . . . . . . 33,690
9 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,779 Influenza and pneumonia 2 . . . . . . . . . . . . . 26,903
10 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . 14,325 Chronic liver disease and cirrhosis . . . . . . . . 25,666
Female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . 914,763 All causes . . . . . . . . . . . . . . . . . . . . . . . 1,339,226
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . 355,424 Diseases of heart . . . . . . . . . . . . . . . . . . 298,840
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . 190,561 Malignant neoplasms . . . . . . . . . . . . . . . . 282,112
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 100,252 Chronic lower respiratory diseases 1,2 . . . . . . 82,543
4 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . 31,538 Cerebrovascular diseases . . . . . . . . . . . . . 82,035
5 . . . . . . . . . . Pneumonia and influenza 2 . . . . . . . . . . . . . . . . 27,045 Alzheimer's disease . . . . . . . . . . . . . . . . . 76,871
6 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . 20,526 Unintentional injuries . . . . . . . . . . . . . . . . 53,652
7 . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . 17,848 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . 36,412
8 . . . . . . . . . . Chronic obstructive pulmonary diseases 1 . . . . . . . 17,425 Influenza and pneumonia 2 . . . . . . . . . . . . . 30,159
9 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . . 10,815 Nephritis, nephrotic syndrome, and nephrosis 3 24,518
10 . . . . . . . . . . Certain conditions originating in the perinatal period . 9,815 Septicemia . . . . . . . . . . . . . . . . . . . . . . 21,388
White
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . 1,738,607 All causes . . . . . . . . . . . . . . . . . . . . . . . 2,306,861
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . 683,347 Diseases of heart . . . . . . . . . . . . . . . . . . 540,857
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . 368,162 Malignant neoplasms . . . . . . . . . . . . . . . . 505,613
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 148,734 Chronic lower respiratory diseases 1,2 . . . . . . 141,766
4 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . 90,122 Unintentional injuries . . . . . . . . . . . . . . . . 125,773
5 . . . . . . . . . . Chronic obstructive pulmonary diseases 1 . . . . . . . 52,375 Cerebrovascular diseases . . . . . . . . . . . . . 116,788
6 . . . . . . . . . . Pneumonia and influenza 2 . . . . . . . . . . . . . . . . 48,369 Alzheimer's disease . . . . . . . . . . . . . . . . . 99,866
7 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . 28,868 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . 61,938
8 . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . 27,069 Influenza and pneumonia 2 . . . . . . . . . . . . . 48,877
9 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . . 25,240 Suicide . . . . . . . . . . . . . . . . . . . . . . . . 39,796
10 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,829 Nephritis, nephrotic syndrome, and nephrosis 3 39,078
Black or
African American
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . 233,135 All causes . . . . . . . . . . . . . . . . . . . . . . . 320,072
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . 72,956 Diseases of heart . . . . . . . . . . . . . . . . . . 75,249
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . 45,037 Malignant neoplasms . . . . . . . . . . . . . . . . 69,389
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 20,135 Cerebrovascular diseases . . . . . . . . . . . . . 17,988
4 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . 13,480 Unintentional injuries . . . . . . . . . . . . . . . . 15,745
5 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,172 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . 13,869
6 . . . . . . . . . . Certain conditions originating in the perinatal period . 6,961 Chronic lower respiratory diseases 1,2 . . . . . . 10,475
7 . . . . . . . . . . Pneumonia and influenza 2 . . . . . . . . . . . . . . . . 5,648 Homicide . . . . . . . . . . . . . . . . . . . . . . . 9,173
8 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . 5,544 Nephritis, nephrotic syndrome, and nephrosis 3 9,170
9 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . . 4,790 Alzheimer's disease . . . . . . . . . . . . . . . . . 8,156
10 . . . . . . . . . . Nephritis, nephrotic syndrome, and nephrosis . . . . . 3,416 Septicemia . . . . . . . . . . . . . . . . . . . . . . 6,647
See footnotes at end of table.
- - - Data not available. Complete coverage of all states for the Hispanic origin variable began in 1997.
1
Between 1998 and 1999, the cause of death title for Chronic obstructive pulmonary diseases in the International Classification of Diseases, 9th Revision (ICD9) was
renamed to Chronic lower respiratory diseases (CLRD) in ICD10.
2
Starting with 1999 data, the rules for selecting CLRD and Pneumonia as the underlying cause of death changed, resulting in an increase in the number of deaths
for CLRD and a decrease in the number of deaths for pneumonia. Therefore, trend data for these two causes of death should be interpreted with caution. For more
information, see Comparability of cause of death between ICD9 and ICD10 in Appendix II, Table V.
3
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome, and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome, and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
Notes in Deaths: Final data for 2011, available from: http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_03.pdf.
NOTES: For cause of death codes based on the ICD9 in 1980 and ICD10 in 2015, see Appendix II, Cause of death; Cause-of-death ranking; Table III; Table IV.
Starting with 2003 data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and
Budget (OMB) standards. The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other
states. The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. See Appendix II, Race; Hispanic origin.
SOURCE: NCHS, National Vital Statistics System: Vital statistics of the United States, vol II, mortality, part A, 1980. Washington, DC: Public Health Service. 1985.
Public-use 2015 Mortality File. Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017.
Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1980 2015
Age and
rank order Cause of death Deaths Cause of death Deaths
Under 1 year
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . 45,526 All causes . . . . . . . . . . . . . . . . . . . . . . . . . 23,455
1 . . . . . . . . . . Congenital anomalies . . . . . . . . . . . . . . . . . . . . 9,220 Congenital malformations/deformations/
chromosomal abnormalities . . . . . . . . . . . . . 4,825
2 . . . . . . . . . . Sudden infant death syndrome . . . . . . . . . . . . . . . 5,510 Disorders related to short gestation and low
birth weight . . . . . . . . . . . . . . . . . . . . . . . 4,084
3 . . . . . . . . . . Respiratory distress syndrome . . . . . . . . . . . . . . . 4,989 Sudden infant death syndrome . . . . . . . . . . . . 1,568
4 . . . . . . . . . . Disorders relating to short gestation and Newborn affected by maternal complications
unspecified low birthweight . . . . . . . . . . . . . . . . 3,648 of pregnancy . . . . . . . . . . . . . . . . . . . . . . 1,522
5 . . . . . . . . . . Newborn affected by maternal complications Unintentional injuries . . . . . . . . . . . . . . . . . . 1,291
of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . 1,572
6 . . . . . . . . . . Intrauterine hypoxia and birth asphyxia . . . . . . . . . . 1,497 Newborn affected by complications of placenta,
cord, and membranes . . . . . . . . . . . . . . . . . 910
7 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,166 Bacterial sepsis of newborn . . . . . . . . . . . . . . 599
8 . . . . . . . . . . Birth trauma . . . . . . . . . . . . . . . . . . . . . . . . . . 1,058 Respiratory distress of newborn . . . . . . . . . . . 462
9 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . . . 1,012 Diseases of circulatory system . . . . . . . . . . . . 428
10 . . . . . . . . . . Newborn affected by complications of placenta, Neonatal hemorrhage . . . . . . . . . . . . . . . . . . 406
cord, and membranes . . . . . . . . . . . . . . . . . . . 985
14 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,187 All causes . . . . . . . . . . . . . . . . . . . . . . . . . 3,965
1 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 3,313 Unintentional injuries . . . . . . . . . . . . . . . . . . 1,235
2 . . . . . . . . . . Congenital anomalies . . . . . . . . . . . . . . . . . . . . 1,026 Congenital malformations/deformations/
chromosomal abnormalities . . . . . . . . . . . . . 435
3 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . 573 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . 369
4 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 338 Malignant neoplasms . . . . . . . . . . . . . . . . . . 354
5 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 Diseases of heart . . . . . . . . . . . . . . . . . . . . 147
6 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . . . 267 Influenza and pneumonia 1 . . . . . . . . . . . . . . . 88
7 . . . . . . . . . . Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . 54
8 . . . . . . . . . . Meningococcal infection. . . . . . . . . . . . . . . . . . . 110 Conditions originating in perinatal period . . . . . . 50
9 . . . . . . . . . . Certain conditions originating in the perinatal period . . 84 Cerebrovascular diseases . . . . . . . . . . . . . . . 42
10 . . . . . . . . . . Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Chronic lower respiratory diseases 1,2 . . . . . . . . 40
514 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,689 All causes . . . . . . . . . . . . . . . . . . . . . . . . . 5,411
1 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 5,224 Unintentional injuries . . . . . . . . . . . . . . . . . . 1,518
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . 1,497 Malignant neoplasms . . . . . . . . . . . . . . . . . . 865
3 . . . . . . . . . . Congenital anomalies . . . . . . . . . . . . . . . . . . . . 561 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . 413
4 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415 Congenital malformations/deformations/
chromosomal abnormalities . . . . . . . . . . . . . 337
5 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 330 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . 298
6 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . . . 194 Diseases of heart . . . . . . . . . . . . . . . . . . . . 210
7 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Chronic lower respiratory diseases 1,2 . . . . . . . . 173
8 . . . . . . . . . . Benign neoplasms . . . . . . . . . . . . . . . . . . . . . . 104 Cerebrovascular diseases . . . . . . . . . . . . . . . 84
9 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . . 95 Influenza and pneumonia 1 . . . . . . . . . . . . . . . 83
10 . . . . . . . . . . Chronic obstructive pulmonary diseases 2 . . . . . . . . 85 In situ neoplasms/benign neoplasms/neoplasms
of uncertain/unknown behavior . . . . . . . . . . . 72
1524 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,027 All causes . . . . . . . . . . . . . . . . . . . . . . . . . 30,494
1 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 26,206 Unintentional injuries . . . . . . . . . . . . . . . . . . 12,514
2 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,537 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . 5,491
3 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,239 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . 4,733
4 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . 2,683 Malignant neoplasms . . . . . . . . . . . . . . . . . . 1,469
5 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,223 Diseases of heart . . . . . . . . . . . . . . . . . . . . 997
6 . . . . . . . . . . Congenital anomalies . . . . . . . . . . . . . . . . . . . . 600 Congenital malformations/deformations/
chromosomal abnormalities . . . . . . . . . . . . . 386
7 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . . 418 Chronic lower respiratory diseases 1,2 . . . . . . . . 202
8 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . . . 348 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . . . 196
9 . . . . . . . . . . Chronic obstructive pulmonary diseases 2 . . . . . . . . 141 Influenza and pneumonia 1 . . . . . . . . . . . . . . . 184
10 . . . . . . . . . . Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Cerebrovascular diseases . . . . . . . . . . . . . . . 166
See footnotes at end of table.
1980 2015
Age and
rank order Cause of death Deaths Cause of death Deaths
2544 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . 108,658 All causes . . . . . . . . . . . . . . . . . . . . . . . . 124,605
1 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . 26,722 Unintentional injuries . . . . . . . . . . . . . . . . . 37,613
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . 17,551 Malignant neoplasms . . . . . . . . . . . . . . . . . 14,613
3 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . 14,513 Diseases of heart . . . . . . . . . . . . . . . . . . . 13,909
4 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . 10,983 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . 13,883
5 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,855 Homicide . . . . . . . . . . . . . . . . . . . . . . . . 7,758
6 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . 4,782 Chronic liver disease and cirrhosis . . . . . . . . . 3,705
7 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . 3,154 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . . 2,784
8 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . 1,472 Cerebrovascular diseases . . . . . . . . . . . . . . 2,355
9 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . 1,467 Human immunodeficiency virus (HIV) disease . . 1,584
10 . . . . . . . . . . Congenital anomalies . . . . . . . . . . . . . . . . . . 817 Septicemia . . . . . . . . . . . . . . . . . . . . . . . 1,208
4564 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . 425,338 All causes . . . . . . . . . . . . . . . . . . . . . . . . 532,279
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . 148,322 Malignant neoplasms . . . . . . . . . . . . . . . . . 159,176
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . 135,675 Diseases of heart . . . . . . . . . . . . . . . . . . . 111,120
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . 19,909 Unintentional injuries . . . . . . . . . . . . . . . . . 40,987
4 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . 18,140 Chronic liver disease and cirrhosis . . . . . . . . . 22,152
5 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . 16,089 Chronic lower respiratory diseases 1,2 . . . . . . . 21,802
6 . . . . . . . . . . Chronic obstructive pulmonary diseases 2 . . . . . . 11,514 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . . 20,378
7 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . 7,977 Cerebrovascular diseases . . . . . . . . . . . . . . 17,423
8 . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,079 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . 16,490
9 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . 5,804 Septicemia . . . . . . . . . . . . . . . . . . . . . . . 8,316
10 . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . 4,019 Nephritis, nephrotic syndrome, and nephrosis 3 . 7,576
65 years and over
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . 1,341,848 All causes . . . . . . . . . . . . . . . . . . . . . . . . 1,992,283
1 . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . 595,406 Diseases of heart . . . . . . . . . . . . . . . . . . . 507,138
2 . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . 258,389 Malignant neoplasms . . . . . . . . . . . . . . . . . 419,389
3 . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . 146,417 Chronic lower respiratory diseases 1,2 . . . . . . . 131,804
4 . . . . . . . . . . Pneumonia and influenza 1 . . . . . . . . . . . . . . . 45,512 Cerebrovascular diseases . . . . . . . . . . . . . . 120,156
5 . . . . . . . . . . Chronic obstructive pulmonary diseases 2 . . . . . . 43,587 Alzheimer's disease . . . . . . . . . . . . . . . . . . 109,495
6 . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . 28,081 Diabetes mellitus 3 . . . . . . . . . . . . . . . . . . . 56,142
7 . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . 25,216 Unintentional injuries . . . . . . . . . . . . . . . . . 51,395
8 . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . 24,844 Influenza and pneumonia . . . . . . . . . . . . . . . 48,774
9 . . . . . . . . . . Nephritis, nephrotic syndrome, and nephrosis . . . . 12,968 Nephritis, nephrotic syndrome, and nephrosis 3 . 41,258
10 . . . . . . . . . . Chronic liver disease and cirrhosis. . . . . . . . . . . 9,519 Septicemia . . . . . . . . . . . . . . . . . . . . . . . 30,817
1
Starting with 1999 data, the rules for selecting CLRD and Pneumonia as the underlying cause of death changed, resulting in an increase in the number of deaths
for CLRD and a decrease in the number of deaths for pneumonia. Therefore, trend data for these two causes of death should be interpreted with caution. For more
information, see Comparability of cause of death between the 9th and 10th revisions of the International Classification of Diseases in Appendix II, Table V.
2
Between 1998 and 1999, the cause of death title for Chronic obstructive pulmonary diseases in the ICD9 was renamed to Chronic lower respiratory diseases (CLRD)
in ICD10.
3
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome, and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome, and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
Notes in Deaths: Final data for 2011, available from: http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_03.pdf.
NOTE: For cause of death codes based on the ICD9 in 1980 and ICD10 in 2015, see Appendix II, Cause of death; Cause-of-death ranking; Table III; Table IV.
SOURCE: NCHS, National Vital Statistics System: Vital statistics of the United States, vol II, mortality, part A, 1980. Washington, DC: Public Health Service. 1985.
Public-use 2015 Mortality File. Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017.
Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
3
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
4
In 1950, rate is for the age group under 5 years.
5
In 1950, rate is for the age group 75 years and over.
6
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Starting with 2003 data, some states began to
collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The multiple-race data for
these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race. Data for additional years
are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The
multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville,
MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The
multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The
multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The
multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards. The
multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II, Race.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville,
MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
and Hispanic origin 1999 2000 2005 2010 2011 2012 2013 2014 2015
and Hispanic origin 1999 2000 2005 2010 2011 2012 2013 2014 2015
All persons Drug poisoning deaths involving opioid analgesics (other than heroin) per 100,000 resident population 4
All ages, age-adjusted . . . . . . . . . . .
2
1.4 1.5 3.7 5.4 5.4 5.1 5.1 5.9 7.0
All ages, crude . . . . . . . . . . . . . . . . 1.4 1.6 3.7 5.4 5.4 5.1 5.1 5.9 7.0
Under 15 years . . . . . . . . . . . . . . . * 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1
1524 years . . . . . . . . . . . . . . . . . . 0.7 0.8 2.7 3.9 3.6 2.8 2.6 3.1 3.9
2534 years . . . . . . . . . . . . . . . . . . 1.9 1.9 5.3 8.5 8.5 7.7 7.5 9.0 11.8
3544 years . . . . . . . . . . . . . . . . . . 3.5 3.7 6.9 9.1 9.3 8.8 8.6 10.3 12.6
4554 years . . . . . . . . . . . . . . . . . . 2.9 3.2 7.9 10.9 11.2 10.6 10.6 11.7 12.9
5564 years . . . . . . . . . . . . . . . . . . 1.0 1.1 3.1 6.2 6.3 6.6 7.5 8.5 9.5
6574 years . . . . . . . . . . . . . . . . . . 0.4 0.4 1.0 1.5 1.8 2.0 2.3 2.7 2.9
7584 years . . . . . . . . . . . . . . . . . . 0.3 0.2 0.6 0.7 0.7 0.9 0.8 0.9 1.0
85 years and over . . . . . . . . . . . . . . . * * 0.9 1.1 0.8 0.8 0.9 0.9 0.9
Male
All ages, age-adjusted 2 . . . . . . . . . . . 2.0 2.0 4.6 6.5 6.5 6.0 5.9 6.9 8.7
All ages, crude . . . . . . . . . . . . . . . . 2.0 2.1 4.6 6.6 6.5 6.0 5.9 7.0 8.7
Under 15 years . . . . . . . . . . . . . . . * * 0.1 0.2 0.1 0.1 0.1 0.1 0.1
1524 years . . . . . . . . . . . . . . . . . . 1.0 1.2 4.2 5.6 5.3 4.2 3.9 4.4 5.4
2534 years . . . . . . . . . . . . . . . . . . 2.7 2.7 7.2 11.7 11.4 10.0 10.0 12.2 16.7
3544 years . . . . . . . . . . . . . . . . . . 5.0 4.9 8.3 10.9 10.9 10.3 9.6 11.9 15.7
4554 years . . . . . . . . . . . . . . . . . . 3.9 4.3 9.4 12.0 12.1 11.1 11.1 12.5 14.2
5564 years . . . . . . . . . . . . . . . . . . 1.1 1.0 3.5 7.0 6.9 7.3 8.0 9.2 10.7
6574 years . . . . . . . . . . . . . . . . . . 0.5 0.3 0.7 1.2 1.7 2.0 2.2 2.5 3.4
7584 years . . . . . . . . . . . . . . . . . . * * 0.6 0.7 0.7 0.7 0.9 0.8 1.0
85 years and over . . . . . . . . . . . . . . . * * * 1.3 * 1.0 1.3 * *
Female
All ages, age-adjusted 2 . . . . . . . . . . . 0.9 1.1 2.8 4.2 4.3 4.2 4.3 4.9 5.4
All ages, crude . . . . . . . . . . . . . . . . 0.9 1.1 2.8 4.2 4.4 4.2 4.4 4.9 5.4
Under 15 years . . . . . . . . . . . . . . . * * * 0.1 0.1 0.1 0.1 0.1 0.1
1524 years . . . . . . . . . . . . . . . . . . 0.3 0.4 1.2 2.1 1.9 1.5 1.4 1.7 2.3
2534 years . . . . . . . . . . . . . . . . . . 1.1 1.2 3.4 5.3 5.5 5.3 5.0 5.7 6.9
3544 years . . . . . . . . . . . . . . . . . . 2.1 2.5 5.6 7.3 7.8 7.3 7.6 8.7 9.6
4554 years . . . . . . . . . . . . . . . . . . 1.9 2.2 6.5 9.8 10.2 10.1 10.1 10.9 11.6
5564 years . . . . . . . . . . . . . . . . . . 0.8 1.1 2.8 5.5 5.7 6.0 6.9 7.8 8.4
6574 years . . . . . . . . . . . . . . . . . . 0.3 0.4 1.2 1.7 1.8 2.0 2.4 2.9 2.4
7584 years . . . . . . . . . . . . . . . . . . 0.4 * 0.6 0.7 0.7 0.9 0.7 1.0 1.0
85 years and over . . . . . . . . . . . . . . . * * 0.8 1.1 0.8 0.7 0.8 1.0 0.9
All ages, age-adjusted 2,3
Male:
White . . . . . . . . . . . . . . . . . . . . 2.2 2.3 5.3 7.7 7.6 7.0 6.8 8.0 10.1
Black or African American . . . . . . . . 1.2 1.2 2.1 2.2 2.4 2.3 2.7 3.9 5.3
American Indian or Alaska Native . . . . * 1.9 4.4 5.3 5.5 5.8 4.8 6.4 6.1
Asian or Pacific Islander . . . . . . . . . * * 0.5 0.8 1.0 0.7 0.9 0.9 1.0
Hispanic or Latino . . . . . . . . . . . . . 2.9 1.7 2.2 2.4 2.6 2.5 2.7 2.7 3.4
White, not Hispanic or Latino . . . . . . 2.1 2.3 5.9 9.0 8.8 8.1 7.9 9.3 11.8
Female:
White . . . . . . . . . . . . . . . . . . . . 1.0 1.2 3.2 4.8 5.1 4.9 5.0 5.6 6.3
Black or African American . . . . . . . . 0.6 0.6 1.4 2.0 2.0 2.0 2.2 2.6 2.9
American Indian or Alaska Native . . . . * * 3.8 4.9 4.6 5.4 5.4 4.6 4.7
Asian or Pacific Islander . . . . . . . . . * * 0.4 0.5 0.4 0.4 0.3 0.5 0.4
Hispanic or Latina . . . . . . . . . . . . . 0.5 0.5 1.0 1.3 1.4 1.5 1.5 1.6 1.6
White, not Hispanic or Latina . . . . . . 1.1 1.3 3.5 5.6 5.8 5.6 5.8 6.5 7.4
See footnotes at end of table.
and Hispanic origin 1999 2000 2005 2010 2011 2012 2013 2014 2015
All persons Drug poisoning deaths involving heroin per 100,000 resident population 4
All ages, age-adjusted 2 . . . . . . . . . . . 0.7 0.7 0.7 1.0 1.4 1.9 2.7 3.4 4.1
All ages, crude . . . . . . . . . . . . . . . . 0.7 0.7 0.7 1.0 1.4 1.9 2.6 3.3 4.0
Under 15 years . . . . . . . . . . . . . . . * * * * * * * * *
1524 years . . . . . . . . . . . . . . . . . . 0.5 0.6 0.7 1.2 1.8 2.2 2.9 3.3 3.8
2534 years . . . . . . . . . . . . . . . . . . 1.0 1.0 1.2 2.2 3.4 4.6 6.3 8.0 9.7
3544 years . . . . . . . . . . . . . . . . . . 1.8 1.5 1.2 1.6 2.2 3.1 4.4 5.9 7.4
4554 years . . . . . . . . . . . . . . . . . . 1.3 1.2 1.4 1.4 2.0 2.8 3.7 4.7 5.6
5564 years . . . . . . . . . . . . . . . . . . 0.3 0.3 0.4 0.7 1.0 1.3 2.1 2.7 3.4
6574 years . . . . . . . . . . . . . . . . . . * * * * 0.2 0.1 0.3 0.5 0.6
7584 years . . . . . . . . . . . . . . . . . . * * * * * * * * *
85 years and over . . . . . . . . . . . . . . . * * * * * * * * *
Male
All ages, age-adjusted 2 . . . . . . . . . . . 1.2 1.1 1.1 1.6 2.3 3.1 4.2 5.2 6.3
All ages, crude . . . . . . . . . . . . . . . . 1.2 1.1 1.1 1.6 2.3 3.0 4.2 5.2 6.2
Under 15 years . . . . . . . . . . . . . . . * * * * * * * * *
1524 years . . . . . . . . . . . . . . . . . . 0.8 0.9 1.0 1.9 2.8 3.2 4.2 4.8 5.2
2534 years . . . . . . . . . . . . . . . . . . 1.6 1.7 2.0 3.5 5.4 7.1 9.9 12.3 14.8
3544 years . . . . . . . . . . . . . . . . . . 3.0 2.6 1.9 2.8 3.6 5.1 6.9 9.2 11.4
4554 years . . . . . . . . . . . . . . . . . . 2.3 2.2 2.3 2.4 3.2 4.5 6.0 7.2 8.7
5564 years . . . . . . . . . . . . . . . . . . 0.5 0.4 0.7 1.1 1.7 2.3 3.6 4.4 5.6
6574 years . . . . . . . . . . . . . . . . . . * * * * 0.3 0.3 0.5 0.9 1.1
7584 years . . . . . . . . . . . . . . . . . . * * * * * * * * *
85 years and over . . . . . . . . . . . . . . . * * * * * * * * *
Female
All ages, age-adjusted 2 . . . . . . . . . . . 0.2 0.2 0.3 0.4 0.6 0.8 1.2 1.6 2.0
All ages, crude . . . . . . . . . . . . . . . . 0.2 0.2 0.3 0.4 0.6 0.8 1.1 1.5 1.9
Under 15 years . . . . . . . . . . . . . . . * * * * * * * * *
1524 years . . . . . . . . . . . . . . . . . . 0.2 0.2 0.3 0.6 0.9 1.1 1.5 1.7 2.2
2534 years . . . . . . . . . . . . . . . . . . 0.3 0.4 0.5 0.9 1.4 2.0 2.6 3.7 4.6
3544 years . . . . . . . . . . . . . . . . . . 0.6 0.5 0.5 0.6 0.8 1.1 1.9 2.6 3.5
4554 years . . . . . . . . . . . . . . . . . . 0.3 0.3 0.5 0.5 0.8 1.1 1.6 2.2 2.7
5564 years . . . . . . . . . . . . . . . . . . * * * 0.3 0.3 0.4 0.7 1.0 1.5
6574 years . . . . . . . . . . . . . . . . . . * * * * * * * * 0.2
7584 years . . . . . . . . . . . . . . . . . . * * * * * * * * *
85 years and over . . . . . . . . . . . . . . . * * * * * * * * *
All ages, age-adjusted 2,3
Male:
White . . . . . . . . . . . . . . . . . . . . 1.2 1.1 1.1 1.8 2.6 3.5 4.7 6.0 7.2
Black or African American . . . . . . . . 1.4 1.6 1.3 1.2 1.6 2.1 3.4 4.1 5.0
American Indian or Alaska Native . . . . * * * * 1.3 1.7 2.6 3.5 4.0
Asian or Pacific Islander . . . . . . . . . * * * * 0.3 0.3 0.5 0.6 0.8
Hispanic or Latino . . . . . . . . . . . . . 2.0 1.6 1.4 1.5 1.7 2.2 2.6 3.2 3.8
White, not Hispanic or Latino . . . . . . 1.1 1.0 1.1 1.9 2.9 3.9 5.3 6.7 8.1
Female:
White . . . . . . . . . . . . . . . . . . . . 0.2 0.2 0.3 0.4 0.6 0.9 1.3 1.8 2.3
Black or African American . . . . . . . . 0.3 0.3 0.3 0.3 0.4 0.5 0.7 1.1 1.3
American Indian or Alaska Native . . . . * * * * 1.0 * 1.0 1.2 1.8
Asian or Pacific Islander . . . . . . . . . * * * * * * * * 0.2
Hispanic or Latina . . . . . . . . . . . . . 0.2 0.1 0.2 0.2 0.3 0.4 0.5 0.7 0.8
White, not Hispanic or Latina . . . . . . 0.2 0.2 0.3 0.5 0.7 1.1 1.5 2.1 2.7
See footnotes at end of table.
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
0.0 Rate more than zero but less than 0.05.
1
Drug poisoning was coded using underlying cause of death according to the 10th Revision of the International Classification of Diseases (ICD10). See
Appendix II, Cause of death; Table IV. Drug poisoning deaths include those resulting from accidental or intentional overdoses of a drug, being given the wrong drug,
taking the wrong drug in error, taking a drug inadvertently, or other misuses of drugs. These deaths are from all manners and intents, including unintentional, suicide,
homicide, undetermined intent, legal intervention, and operations of war.
2
Age-adjusted rates are calculated using the year 2000 standard population with unrounded population numbers. See Appendix II, Age adjustment.
3
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
4
Opioid analgesics include opioids such as hydrocodone, codeine, and methadone, and synthetic narcotics such as fentanyl, tramadol, and propoxyphene (removed
from the market in 2010). Drug poisoning deaths involving opioid analgesics include those with an underlying cause of drug poisoning and with an opioid analgesic
mentioned in the ICD10 multiple causes of death. Drug poisoning deaths involving heroin include those with an underlying cause of drug poisoning and with heroin
mentioned in the ICD10 multiple causes of death. See Appendix I, National Vital Statistics System (NVSS), Mortality Multiple Cause-of-Death File, See Appendix
II, Cause of death; Table IV. Drug-poisoning deaths may involve multiple drugs. Deaths involving both opioid analgesics and heroin are included in the death rate for
opioid analgesics and the death rate for heroin. Opioid analgesic death rates include deaths involving fentanyl, a synthetic opioid. A sharp increase in deaths involving
synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured, or non-pharmaceutical,
fentanyl. Illicitly manufactured fentanyl cannot be distinguished from pharmaceutical fentanyl in death certificate data. For more information, see CDC health advisory:
Increases in fentanyl drug confiscations and fentanyl-related overdose fatalities. Available from: http://emergency.cdc.gov/han/han00384.asp, and Rudd RA, Aleshire
N, Zibbell JE, Gladden M. Increases in drug and opioid overdose deathsUnited States, 20002014. MMWR 2016;64(50):137882. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm?s_cid=mm6450a3_w. For more information on the type of drugs commonly involved in drug
overdose deaths, see: Warner M, Trinidad JP, Bastian BA, et al. Drugs most frequently involved in drug overdose deaths: United States, 20102014. National vital
statistics reports; vol 65 no 10. Hyattsville, MD: NCHS. 2016. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_10.pdf. Metabolic breakdown of
heroin into morphine in the body can make it difficult to distinguish between deaths from heroin and deaths from morphine based on the information on the death
certificate. Some deaths reported to involve morphine could be deaths from heroin. This may result in an undercount of heroin-related deaths. For more information,
see Hedegaard H, Chen LH, Warner M. Drug-poisoning deaths involving heroin: United States, 20002013. NCHS data brief, no 190. Hyattsville, MD: NCHS. 2015.
Available from: http://www.cdc.gov/nchs/data/databriefs/db190.htm. In 19992015, 17%25% of drug poisoning deaths did not include specific information on the
death certificate on the type of drug that was involved. Some of these deaths could have potentially involved heroin or opioid analgesics. For more information, see
NCHS Health E-Stat available from: http://www.cdc.gov/nchs/data/hestat/drug_poisoning/drug_poisoning.htm. For more information on the enhancement of mortality
statistics using information from the death certificate, see: Trinidad JP, Warner M, Bastian BA, et al. Using literal text from the death certificate to enhance mortality
statistics: Characterizing drug involvement in deaths. National vital statistics reports; vol 65 no 9. Hyattsville, MD: NCHS. 2016. Available from: https://www.cdc.gov/
nchs/data/nvsr/nvsr65/nvsr65_09.pdf.
NOTES: Rates for 1999 were computed using intercensal population estimates based on the 1990 and 2000 censuses. Rates for 2000 were computed based on 2000
bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal population estimates based on the
2000 and 2010 censuses. Rates for 2010 were based on 2010 bridged-race April 1 census counts. Rates for 2011 and beyond were computed using 2010-based
postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the presentation of unstable age-specific
death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related statistics, see the Web-based Injury
Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003 data, some states allowed the
reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1; Deaths: Final data for 2015. National vital statistics reports Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group under 15 years.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related
statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003
data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards.
The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II,
Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group under 15 years.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Figures for 2001 include September 11-related
deaths for which death certificates were filed as of October 24, 2002. See Appendix II, Cause of death; Table IV for terrorism-related ICD10 codes. Age groups were
selected to minimize the presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For
additional injury-related statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.
html. Starting with 2003 data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and
Budget (OMB) standards. The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other
states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.
htm. Some data have been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 19801998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Figures for 2001 include September 11-related
deaths for which death certificates were filed as of October 24, 2002. See Appendix II, Cause of death; Table IV for terrorism-related ICD10 codes. Age groups were
selected to minimize the presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For
additional injury-related statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.
html. Starting with 2003 data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and
Budget (OMB) standards. The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other
states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.
htm. Some data have been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 19401960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from:
http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
Sex, race, Hispanic origin, and age 1970 1 1980 1 1990 1 1995 1 2000 2 2010 2 2014 2 2015 2
Sex, race, Hispanic origin, and age 1970 1 1980 1 1990 1 1995 1 2000 2 2010 2 2014 2 2015 2
Black or
African American male 4 Deaths per 100,000 resident population
All ages, age-adjusted 3 . . . . . . 70.8 60.1 56.3 49.2 34.2 31.8 31.5 36.4
All ages, crude . . . . . . . . . . . 60.8 57.7 61.9 52.9 36.1 33.4 32.9 38.1
114 years . . . . . . . . . . . . . . 5.3 3.0 4.4 4.4 1.8 1.9 1.9 2.1
1524 years . . . . . . . . . . . . . 97.3 77.9 138.0 138.7 89.3 73.2 68.9 79.7
2544 years . . . . . . . . . . . . . 126.2 114.1 90.3 70.2 54.1 57.3 57.4 68.1
2534 years . . . . . . . . . . . . 145.6 128.4 108.6 92.3 74.8 78.2 71.3 84.9
3544 years . . . . . . . . . . . . 104.2 92.3 66.1 46.3 34.3 35.2 41.0 47.9
4564 years . . . . . . . . . . . . . 71.1 55.6 34.5 28.3 18.4 16.5 16.9 18.7
65 years and over . . . . . . . . . . 30.6 29.7 23.9 21.8 13.8 9.4 10.9 10.0
American Indian or
Alaska Native male 4
All ages, age-adjusted 3 . . . . . . -- 24.0 19.4 19.4 13.1 11.7 12.9 14.4
All ages, crude . . . . . . . . . . . -- 27.5 20.5 20.9 13.2 12.5 12.4 14.2
1524 years . . . . . . . . . . . . . -- 55.3 49.1 40.9 26.9 26.0 17.7 26.4
2544 years . . . . . . . . . . . . . -- 43.9 25.4 31.2 16.6 16.9 19.3 18.7
4564 years . . . . . . . . . . . . . -- * * 14.2 12.2 11.1 12.6 14.0
65 years and over . . . . . . . . . . -- * * * * * * *
Asian or
Pacific Islander male 4
All ages, age-adjusted 3 . . . . . . -- 7.8 8.8 9.2 6.0 4.2 3.7 4.4
All ages, crude . . . . . . . . . . . -- 8.2 9.4 10.0 6.2 4.4 3.8 4.7
1524 years . . . . . . . . . . . . . -- 10.8 21.0 24.3 9.3 6.8 6.3 8.0
2544 years . . . . . . . . . . . . . -- 12.8 10.9 10.6 8.1 6.0 4.8 6.0
4564 years . . . . . . . . . . . . . -- 10.4 8.1 8.2 7.4 4.4 4.1 5.0
65 years and over . . . . . . . . . . -- * * * * 3.9 3.4 3.7
Hispanic or Latino male 4,5
All ages, age-adjusted 3 . . . . . . -- -- 27.6 23.8 13.6 10.5 9.4 10.1
All ages, crude . . . . . . . . . . . -- -- 29.9 26.2 14.2 10.5 9.4 10.2
114 years . . . . . . . . . . . . . . -- -- 2.6 2.8 1.0 0.6 0.5 0.5
1524 years . . . . . . . . . . . . . -- -- 55.5 61.7 30.8 20.9 17.2 19.6
2544 years . . . . . . . . . . . . . -- -- 42.7 31.4 17.3 14.4 14.1 15.0
2534 years . . . . . . . . . . . . -- -- 47.3 36.4 20.3 18.0 15.7 17.7
3544 years . . . . . . . . . . . . -- -- 35.4 24.2 13.2 10.2 12.3 11.9
4564 years . . . . . . . . . . . . . -- -- 21.4 17.2 12.0 9.1 7.9 8.0
65 years and over . . . . . . . . . . -- -- 19.1 16.5 12.2 9.9 7.8 9.1
White, not Hispanic
or Latino male 5
All ages, age-adjusted 3 . . . . . . -- -- 20.6 18.6 15.5 16.6 17.3 18.0
All ages, crude . . . . . . . . . . . -- -- 20.4 18.5 15.7 17.6 18.7 19.4
114 years . . . . . . . . . . . . . . -- -- 1.6 1.6 1.0 0.9 1.2 1.0
1524 years . . . . . . . . . . . . . -- -- 24.1 23.5 16.2 14.2 15.4 16.4
2544 years . . . . . . . . . . . . . -- -- 23.3 21.4 17.9 19.4 19.4 21.2
2534 years . . . . . . . . . . . . -- -- 24.7 22.5 17.2 18.9 19.2 20.9
3544 years . . . . . . . . . . . . -- -- 21.6 20.4 18.4 19.9 19.7 21.5
4564 years . . . . . . . . . . . . . -- -- 22.7 19.5 17.8 22.8 23.4 23.7
65 years and over . . . . . . . . . . -- -- 37.4 32.5 29.0 27.6 29.9 29.8
White female 4
All ages, age-adjusted 3 . . . . . . 4.0 4.2 3.8 3.5 2.7 2.7 3.1 3.2
All ages, crude . . . . . . . . . . . 3.7 4.1 3.8 3.5 2.7 2.8 3.2 3.3
1524 years . . . . . . . . . . . . . 3.4 5.1 4.8 4.5 2.8 2.3 2.6 2.8
2544 years . . . . . . . . . . . . . 6.9 6.2 5.3 4.9 3.9 3.7 4.0 4.4
4564 years . . . . . . . . . . . . . 5.0 5.1 4.5 4.0 3.5 4.1 4.7 4.9
65 years and over . . . . . . . . . . 2.2 2.5 3.1 2.8 2.4 2.5 2.7 2.8
See footnotes at end of table.
Sex, race, Hispanic origin, and age 1970 1 1980 1 1990 1 1995 1 2000 2 2010 2 2014 2 2015 2
Black or
African American female 4 Deaths per 100,000 resident population
All ages, age-adjusted 3 . . . . . . 11.1 8.7 7.3 6.2 3.9 3.3 3.2 3.6
All ages, crude . . . . . . . . . . . 10.0 8.8 7.8 6.5 4.0 3.3 3.2 3.7
1524 years . . . . . . . . . . . . . 15.2 12.3 13.3 13.2 7.6 6.4 6.2 6.8
2544 years . . . . . . . . . . . . . 19.4 16.1 12.4 9.8 6.5 5.6 5.3 6.2
4564 years . . . . . . . . . . . . . 10.2 8.2 4.8 4.1 3.1 2.2 2.1 2.3
65 years and over . . . . . . . . . . 4.3 3.1 3.1 2.6 1.3 * 1.4 1.1
American Indian or
Alaska Native female 4
All ages, age-adjusted 3 . . . . . . -- 5.8 3.3 3.8 2.9 2.6 2.4 2.6
All ages, crude . . . . . . . . . . . -- 5.8 3.4 4.1 2.9 2.4 2.4 2.5
1524 years . . . . . . . . . . . . . -- * * * * * * *
2544 years . . . . . . . . . . . . . -- 10.2 * 7.0 5.5 3.7 5.6 4.3
4564 years . . . . . . . . . . . . . -- * * * * * * *
65 years and over . . . . . . . . . . -- * * * * * * *
Asian or
Pacific Islander female 4
All ages, age-adjusted 3 . . . . . . -- 2.0 1.9 2.0 1.1 0.6 0.7 0.8
All ages, crude . . . . . . . . . . . -- 2.1 2.1 2.1 1.2 0.6 0.8 0.8
1524 years . . . . . . . . . . . . . -- * * 3.9 * * * *
2544 years . . . . . . . . . . . . . -- 3.2 2.7 2.7 1.5 1.1 0.8 1.0
4564 years . . . . . . . . . . . . . -- * * * * * 1.3 0.8
65 years and over . . . . . . . . . . -- * * * * * * *
Hispanic or Latina female 4,5
All ages, age-adjusted 3 . . . . . . -- -- 3.3 3.1 1.8 1.3 1.4 1.5
All ages, crude . . . . . . . . . . . -- -- 3.6 3.3 1.8 1.3 1.4 1.5
1524 years . . . . . . . . . . . . . -- -- 6.9 6.1 2.9 2.1 2.6 2.5
2544 years . . . . . . . . . . . . . -- -- 5.1 4.7 2.5 1.8 1.9 2.2
4564 years . . . . . . . . . . . . . -- -- 2.4 2.4 2.2 1.5 1.2 1.6
65 years and over . . . . . . . . . . -- -- * * * * * *
White, not Hispanic
or Latina female 5
All ages, age-adjusted 3 . . . . . . -- -- 3.7 3.4 2.8 3.0 3.4 3.6
All ages, crude . . . . . . . . . . . -- -- 3.7 3.5 2.9 3.1 3.6 3.7
1524 years . . . . . . . . . . . . . -- -- 4.3 4.1 2.7 2.3 2.6 2.9
2544 years . . . . . . . . . . . . . -- -- 5.1 4.8 4.2 4.2 4.6 5.0
4564 years . . . . . . . . . . . . . -- -- 4.6 4.1 3.6 4.4 5.2 5.4
65 years and over . . . . . . . . . . -- -- 3.2 2.8 2.4 2.6 2.9 3.0
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Underlying cause of death was coded according to the 8th Revision of the International Classification of Diseases (ICD) in 1970 and 9th Revision in 19801998. See
NOTES: Starting with Health, United States, 2003, rates for 19911999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 20012009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond
were computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related
statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003
data, some states began to collect information on more than one race on the death certificate, according to 1997 Office of Management and Budget (OMB) standards.
The multiple-race data for these states were bridged to the single-race categories of the 1977 OMB standards, for comparability with other states. See Appendix II,
Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Some data have
been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 19851996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final data for 2015. National vital statistics reports. Hyattsville,
MD: NCHS; 2017. Available from: http://www.cdc.gov/nchs/products/nvsr.htm. See Appendix I, National Vital Statistics System (NVSS).
Number of deaths
Total workforce . . . . . . . . . . . . . . . . . . 5,575 5,734 4,690 4,628 4,585 4,821 4,836
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . 5,129 5,328 4,322 4,277 4,265 4,454 4,492
Female . . . . . . . . . . . . . . . . . . . . . . . 446 406 368 351 319 367 344
Unspecified . . . . . . . . . . . . . . . . . . . . 0 0 0 0 1 0 0
Age
Under 16 years . . . . . . . . . . . . . . . . . . 25 23 16 19 5 8 12
1617 years . . . . . . . . . . . . . . . . . . . . 28 31 18 10 9 14 12
1819 years . . . . . . . . . . . . . . . . . . . . 84 111 56 59 57 42 50
2024 years . . . . . . . . . . . . . . . . . . . . 462 403 245 287 279 292 329
2534 years . . . . . . . . . . . . . . . . . . . . 1,018 1,017 785 736 777 753 758
3544 years . . . . . . . . . . . . . . . . . . . . 1,329 1,243 868 829 853 860 864
4554 years . . . . . . . . . . . . . . . . . . . . 1,301 1,389 1,169 1,161 1,115 1,161 1,130
5564 years . . . . . . . . . . . . . . . . . . . . 802 933 948 936 933 1,007 1,031
65 years and over . . . . . . . . . . . . . . . . . 523 578 582 588 557 684 650
Unspecified . . . . . . . . . . . . . . . . . . . . 3 6 3 3 0 0 0
Race and Hispanic origin
Hispanic or Latino . . . . . . . . . . . . . . . . 794 923 707 748 817 804 903
Not Hispanic or Latino . . . . . . . . . . . . . . 4,781 4,811 3,983 3,880 3,768 4,017 3,933
White . . . . . . . . . . . . . . . . . . . . . . 3,988 3,977 3,363 3,177 3,125 3,332 3,241
Black or African American . . . . . . . . . . 543 584 412 486 439 475 495
American Indian or Alaska Native . . . . . . 42 50 32 37 35 34 36
Asian . . . . . . . . . . . . . . . . . . . . . . . 147 154 143 147 125 137 114
Native Hawaiian or Other Pacific Islander . 11 9 6 7 7 5 9
Multiple races . . . . . . . . . . . . . . . . . 3 * 8 5 12 20 12
Other races or not reported . . . . . . . . . 47 35 19 21 25 14 26
Industry 1
Private sector . . . . . . . . . . . . . . . . . . . 5,043 5,214 4,206 4,175 4,101 4,386 4,379
Agriculture, forestry, fishing, and hunting . 709 715 621 509 500 584 570
Mining 2 . . . . . . . . . . . . . . . . . . . . . 141 159 172 181 155 183 120
Utilities . . . . . . . . . . . . . . . . . . . . . 32 30 26 23 24 17 22
Construction . . . . . . . . . . . . . . . . . . 1,131 1,192 774 806 828 899 937
Manufacturing . . . . . . . . . . . . . . . . . 420 393 329 327 312 349 353
Wholesale trade . . . . . . . . . . . . . . . . 191 209 191 204 201 191 175
Retail trade . . . . . . . . . . . . . . . . . . . 344 400 311 273 263 272 269
Transportation and warehousing . . . . . . 808 885 661 741 733 766 765
Information . . . . . . . . . . . . . . . . . . . 64 65 43 42 40 35 42
Finance and insurance . . . . . . . . . . . . 45 42 24 21 21 29 19
Real estate and rental and leasing . . . . . 84 57 89 64 66 88 64
Professional and technical services . . . . 97 83 76 57 87 80 76
Management, administrative, and waste
services 3. . . . . . . . . . . . . . . . . . . . -- -- -- 352 343 345 401
Educational services . . . . . . . . . . . . . 41 46 30 34 32 40 30
Health care and social assistance . . . . . 102 104 141 107 103 106 109
Arts, entertainment, and recreation . . . . . 88 77 84 80 69 81 82
Accommodation and food services . . . . . 187 136 154 152 138 135 143
Other services (except public
administration) . . . . . . . . . . . . . . . . 194 210 192 199 186 186 202
Government 4 . . . . . . . . . . . . . . . . . . . 532 520 484 453 484 435 457
See footnotes at end of table.
NOTES: Fatal work injuries are based on revised data and may differ from originally published data from CFOI. See Appendix I, Census of Fatal Occupational Injuries
(CFOI). Private sector totals include injuries with unknown industry. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries. Revised annual data. See Appendix I, Census of Fatal Occupational
Injuries (CFOI).
Disease 1950 1960 1970 1980 1990 2000 2010 2014 2015
1
Anti-HCV antibody test became available May 1990.
2
Not nationally notifiable. National surveillance case definition revised in 2008; probable cases not previously reported.
3
Cases of vaccine-associated paralytic poliomyelitis caused by polio vaccine virus.
4
Prior to 2010 data, cases of spotted fever rickettsiosis were reported as Rocky Mountain spotted fever (RMSF). Because serologic tests commonly used to diagnose
RMSF exhibit cross-reactivity between spotted fever rickettsial pathogens, some cases reported as RMSF might actually be disease caused by other spotted fever
rickettsial infections, and therefore are more correctly referred to as spotted fever rickettsiosis starting with 2010 data.
5
Case reporting for tuberculosis began in 1953. Data prior to 1975 are not comparable with subsequent years because of changes in reporting criteria effective in 1975.
6
For 1950, data for Alaska and Hawaii were not included. Starting with 1991, data include both civilian and military cases. Cases and rates shown do not include U.S.
outlying areas of Guam, Puerto Rico, and the Virgin Islands.
7
Includes stage of syphilis not stated.
8
Includes cases of unknown duration.
9
Rates include all cases of congenitally acquired syphilis per 100,000 live births. Cases of congenitally acquired syphilis were reported through 1994. Starting with 1995
data, only congenital syphilis for cases under 1 year of age were reported. See STD Surveillance Report for congenital syphilis rates.
10
Prior to 1994, chlamydia was not notifiable. In 19941999, cases for New York were exclusively reported by New York City. Starting with 2000 data, cases for New
York include the entire state.
11
Data for 1994 do not include cases from Georgia.
NOTES: The total resident population was used to calculate all rates except for sexually transmitted disease rates prior to 1991; STD rates prior to 1991 used the
civilian resident population. See Appendix I, Sexually Transmitted Disease (STD) Surveillance; Population Census and Population Estimates. Population data from states
where diseases were not notifiable or not available were excluded from the rate calculation; see Appendix II, Notifiable disease. See Appendix I, National Notifiable
Disease Surveillance System (NNDSS), for information on underreporting of notifiable diseases. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC, Office of Public Health Scientific Services (OPHSS); Center for Surveillance, Epidemiology and Laboratory Services (CSELS); Division of Health
Informatics and Surveillance (DHIS). MMWR 2016;63(54):1152 and CDC. Available from: http://www.cdc.gov/mmwr/mmwr_nd/index.html. Sexually transmitted
disease surveillance, 2015. Atlanta, GA: U.S. Department of Health and Human Services, 2016. Available from: http://www.cdc.gov/std/stats/. See Appendix I, National
Notifiable Diseases Surveillance System (NNDSS); Sexually Transmitted Disease (STD) Surveillance.
1
Based on diagnoses during 20102015 that were reported to CDC through June 30, 2016. Includes persons with a diagnosis of HIV infection regardless of the stage
of disease (stage 0, 1, 2, 3 [AIDS], or unknown). In 2014, the criteria used to define HIV diagnoses changed. Cases diagnosed before 2014 were classified according to
the 2008 HIV case definition. Starting with 2014 data, cases were classified according to the new definition. Because of the change in case definition, HIV diagnoses
prior to 2014 are not strictly comparable to HIV diagnoses for 2014. The vertical line in the table represents the discontinuity in the HIV diagnosis trend. See Appendix
II, Human immunodeficiency virus (HIV) disease and Acquired immunodeficiency syndrome (AIDS) for discussion of HIV diagnoses reporting definitions and other
2
Data for 2015 are preliminary; CDC cautions against using the 2015 data in this report for assessments of trends.
3
Numbers and rates are point estimates that result from statistical adjustments for missing risk factor information. See Appendix I, National HIV Surveillance System.
4
All persons totals were calculated independent of values for subpopulations. Consequently, sums of subpopulations may not equal totals for all persons.
5
Hispanic origin and race categories are mutually exclusive.
6
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
NOTES: Data shown are for the 50 states and the District of Columbia, and include newly diagnosed and reported cases. This table does not present HIV incidence
or prevalence data. Rates were calculated using vintage 2015 population estimates from the U.S. Census Bureau. Variations in trends among subpopulations may be
due to differences in testing behaviors, targeted HIV testing initiatives, or the numbers of new HIV infections in some subpopulations. Caution should be used when
interpreting data on diagnoses of HIV infection. HIV surveillance reports may not be representative of all persons with HIV for several reasons: not all infected persons
have been tested and diagnosed; results of anonymous tests are not reported to the name-based HIV registries of state and local health departments; testing patterns
are influenced by the extent to which testing is routinely offered to specific groups; and surveillance and reporting practices among jurisdictions differ. The data
presented here are estimates of the minimum number of persons for whom HIV infection has been diagnosed and reported to the surveillance system. Data have been
SOURCE: CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Division of HIV/AIDS Prevention. HIV Surveillance Report. Diagnoses of HIV
infection in the United States and Dependent Areas, 2015 (vol. 27). Atlanta, GA: U.S. Department of Health and Human Services, CDC. Published November 2016.
Percent of children
Under 18 years 3 . . . . . . . . . . . . . . -- -- 8.7 8.5 5.4 5.7 5.4 4.5
Age
04 years . . . . . . . . . . . . . . . . . -- -- 6.1 4.4 4.3 4.7 4.2 2.9
517 years . . . . . . . . . . . . . . . . . -- -- 9.6 10.0 5.7 6.1 5.8 5.1
59 years . . . . . . . . . . . . . . . . -- -- 9.1 9.4 5.6 6.3 6.1 5.5
1017 years . . . . . . . . . . . . . . . -- -- 9.9 10.3 5.8 5.9 5.7 4.8
Sex
Male . . . . . . . . . . . . . . . . . . . . -- -- 9.9 9.8 6.2 6.6 6.3 5.2
Female . . . . . . . . . . . . . . . . . . -- -- 7.3 7.1 4.5 4.7 4.4 3.8
Race 4
White only . . . . . . . . . . . . . . . . . -- -- 7.7 7.5 5.0 5.2 4.9 4.1
Black or African American only . . . . . . -- -- 13.0 13.4 7.0 8.0 7.6 6.8
American Indian or Alaska Native only . . -- -- 12.2 8.9 6.4 *8.7 *6.1 *4.6
Asian only . . . . . . . . . . . . . . . . . -- -- 4.8 5.2 4.3 4.7 3.3 2.9
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . -- -- * * -- * * *
2 or more races . . . . . . . . . . . . . . -- -- 13.5 10.9 -- 7.3 8.8 6.1
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . -- -- 7.6 7.9 4.8 4.2 4.6 4.2
Not Hispanic or Latino. . . . . . . . . . . -- -- 8.9 8.6 5.5 6.0 5.6 4.6
White only. . . . . . . . . . . . . . . . -- -- 7.9 7.5 5.1 5.5 5.0 4.0
Black or African American only . . . . . -- -- 13.0 13.4 7.0 7.9 7.5 6.8
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . . -- -- 10.4 10.9 6.1 7.1 6.5 6.2
100%199%. . . . . . . . . . . . . . . . -- -- 8.6 8.5 5.3 5.4 5.2 4.4
200%399%. . . . . . . . . . . . . . . . -- -- 8.3 7.9 5.0 5.3 5.2 4.0
400% or more . . . . . . . . . . . . . . . -- -- 7.9 6.9 5.2 5.5 4.9 3.7
Health insurance status
at the time of interview 6
Insured . . . . . . . . . . . . . . . . . . -- -- 9.0 8.5 5.6 5.9 5.6 4.5
Private . . . . . . . . . . . . . . . . . -- -- 8.0 7.4 5.0 5.3 5.0 3.9
Medicaid . . . . . . . . . . . . . . . . -- -- 11.4 10.2 7.7 7.7 7.1 5.5
Uninsured . . . . . . . . . . . . . . . . . -- -- 5.6 6.9 3.9 4.3 3.3 3.7
See footnotes at end of table.
Percent of children
Under 18 years 3 . . . . . . . . . . . . . . . . . . 3.4 3.6 3.8 5.6 7.4 8.1 9.6 11.8
Age
04 years . . . . . . . . . . . . . . . . . . . . . 3.8 4.0 4.3 5.7 8.1 8.7 11.0 13.2
517 years . . . . . . . . . . . . . . . . . . . . . 3.3 3.4 3.6 5.6 7.2 7.9 9.1 11.3
59 years . . . . . . . . . . . . . . . . . . . . 3.1 3.6 3.5 6.0 7.5 8.6 10.0 12.7
1017 years . . . . . . . . . . . . . . . . . . . 3.4 3.3 3.6 5.3 7.1 7.5 8.6 10.4
Sex
Male . . . . . . . . . . . . . . . . . . . . . . 3.4 3.7 3.8 5.6 7.3 7.9 9.5 11.8
Female . . . . . . . . . . . . . . . . . . . . . . 3.5 3.4 3.8 5.6 7.6 8.4 9.8 11.8
Race 4
White only . . . . . . . . . . . . . . . . . . . . . 3.5 3.6 3.8 5.4 7.1 7.6 9.0 10.7
Black or African American only . . . . . . . . . . 3.1 3.0 3.7 5.8 9.0 10.4 12.4 16.4
American Indian or Alaska Native only . . . . . . * *4.8 * *4.0 *4.1 *9.1 11.3 9.0
Asian only . . . . . . . . . . . . . . . . . . . . . 3.9 4.4 4.3 6.0 8.0 8.4 7.5 11.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . . -- 5.2 4.6 7.8 -- 10.9 14.0 15.6
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . . . 2.1 2.5 2.8 4.6 5.5 5.6 7.2 9.8
Not Hispanic or Latino. . . . . . . . . . . . . . . 3.7 3.8 4.0 5.9 7.8 8.7 10.2 12.5
White only. . . . . . . . . . . . . . . . . . . . 3.8 3.9 4.1 5.8 7.5 8.2 9.7 11.3
Black or African American only . . . . . . . . . 3.1 3.1 3.7 5.6 9.0 10.4 12.4 16.5
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . . . . . . 3.3 3.2 3.3 5.1 7.3 7.1 9.0 11.8
100%199%. . . . . . . . . . . . . . . . . . . . 3.0 3.4 3.8 5.4 7.2 7.6 8.7 11.2
200%399%. . . . . . . . . . . . . . . . . . . . 3.2 3.4 3.8 5.5 7.3 8.5 10.0 12.0
400% or more . . . . . . . . . . . . . . . . . . . 4.2 4.0 4.1 6.3 7.9 8.8 10.5 12.2
Health insurance status
at the time of interview 6
Insured . . . . . . . . . . . . . . . . . . . . . . 3.5 3.7 3.9 5.7 7.7 8.5 10.0 12.0
Private . . . . . . . . . . . . . . . . . . . . . 3.5 3.7 4.0 5.9 7.4 8.5 10.1 12.0
Medicaid . . . . . . . . . . . . . . . . . . . . 3.6 3.7 3.6 5.2 8.4 8.4 9.5 11.9
Uninsured . . . . . . . . . . . . . . . . . . . . . 2.6 2.4 3.0 4.4 5.9 5.3 6.8 9.1
See footnotes at end of table.
Percent of children
Under 18 years 3. . . . . . . . . . . . . . . . . . . . . 17.5 17.7 17.3 15.6 7.1 6.7 5.8 5.0
Age
04 years . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 10.4 10.1 9.1 13.7 12.8 11.0 9.2
517 years . . . . . . . . . . . . . . . . . . . . . . . . 19.9 20.3 20.0 18.0 4.8 4.5 3.8 3.4
59 years . . . . . . . . . . . . . . . . . . . . . . . 17.3 18.1 17.9 16.7 7.1 6.9 5.7 5.2
1017 years . . . . . . . . . . . . . . . . . . . . . . 21.6 21.7 21.2 18.9 3.2 2.9 2.7 2.3
Sex
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.6 18.8 18.9 17.3 7.3 6.9 5.9 5.1
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3 16.5 15.6 13.9 6.9 6.5 5.6 4.8
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . 17.9 18.5 17.8 15.7 7.4 7.2 6.3 5.4
Black or African American only . . . . . . . . . . . . 16.2 15.6 15.2 15.1 5.9 5.0 4.1 3.5
American Indian or Alaska Native only . . . . . . . 15.2 16.4 16.5 12.9 *10.8 *6.3 *5.1 7.2
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 15.3 12.6 11.3 12.2 3.7 2.6 3.3 2.1
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . . . . -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . . . . . -- 20.9 20.8 20.3 -- 7.4 5.0 5.0
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . . . . . 12.4 12.4 12.8 12.8 6.1 6.7 6.2 5.5
Not Hispanic or Latino . . . . . . . . . . . . . . . . . 18.4 18.8 18.3 16.5 7.3 6.7 5.7 4.8
White only. . . . . . . . . . . . . . . . . . . . . . . 19.1 19.9 19.4 17.0 7.7 7.3 6.3 5.4
Black or African American only . . . . . . . . . . 16.3 15.5 15.1 15.2 5.9 4.9 4.0 3.4
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . . . . . . . . . 14.3 14.0 14.2 13.3 8.3 7.9 6.7 6.2
100%199%. . . . . . . . . . . . . . . . . . . . . . . 15.4 15.6 16.0 14.2 7.1 6.8 5.7 4.9
200%399%. . . . . . . . . . . . . . . . . . . . . . . 18.5 18.1 17.7 16.2 6.8 6.5 5.6 4.7
400% or more . . . . . . . . . . . . . . . . . . . . . . 20.3 21.1 19.7 18.1 6.6 6.1 5.5 4.3
Health insurance status
at the time of interview 6
Insured . . . . . . . . . . . . . . . . . . . . . . 18.0 18.3 17.7 15.7 7.3 6.9 5.8 5.0
Private . . . . . . . . . . . . . . . . . . . . . . . . . 18.8 19.2 18.5 16.9 6.6 6.4 5.2 4.5
Medicaid . . . . . . . . . . . . . . . . . . . . . . . 15.0 16.0 16.1 14.1 10.2 8.7 7.4 5.7
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . 14.3 12.6 13.5 14.1 5.9 4.9 5.4 4.4
See footnotes at end of table.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
19902013
Site, sex, race, and Hispanic origin 1990 1995 2000 2003 2005 2010 2011 2012 2013 APC 1
All persons . . . . . . . . . . . . . . . . . . . . . 475.8 471.4 475.2 463.4 460.8 450.7 443.0 429.3 419.5
0.5
White . . . . . . . . . . . . . . . . . . . . . . 483.3 477.4 485.8 474.1 473.1 462.0 454.8 439.5 429.9
0.4
Black or African American . . . . . . . . . . 515.2 539.4 525.9 514.3 505.3 483.9 476.8 464.4 444.2
0.7
American Indian or Alaska Native 3 . . . . . 348.1 371.7 365.9 380.6 404.1 406.8 377.7 357.0 367.6 0.1
Asian or Pacific Islander . . . . . . . . . . . 335.4 340.6 341.5 334.4 331.9 324.1 321.8 310.5 305.3
0.5
Hispanic or Latino 4 . . . . . . . . . . . . . . 356.1 359.9 362.0 358.3 365.0 348.9 351.3 336.7 327.4
0.3
White, not Hispanic or Latino 4 . . . . . . . . 495.2 491.2 503.6 492.4 491.3 482.7 474.6 459.5 451.1
0.3
Male . . . . . . . . . . . . . . . . . . . . . . . . 584.1 564.7 565.6 545.9 534.9 512.8 498.3 468.5 454.4
1.0
White . . . . . . . . . . . . . . . . . . . . . . 591.1 563.5 569.8 550.9 543.6 519.9 506.6 475.1 460.4
1.0
Black or African American . . . . . . . . . . 688.5 742.9 707.2 669.6 637.6 596.0 571.6 548.4 523.1
1.5
American Indian or Alaska Native 3 . . . . . 395.1 424.0 374.7 448.0 426.4 456.7 403.9 350.0 377.3 0.3
Asian or Pacific Islander . . . . . . . . . . . 386.0 398.9 400.4 387.5 371.8 347.2 343.9 317.3 309.9
1.1
Hispanic or Latino 4 . . . . . . . . . . . . . . 417.5 440.7 436.6 423.9 426.9 398.8 392.1 365.6 343.9
0.9
White, not Hispanic or Latino 4 . . . . . . . . 606.7 577.3 588.9 569.3 561.8 540.8 526.9 495.4 483.2
0.9
Female . . . . . . . . . . . . . . . . . . . . . . . 411.5 410.6 414.0 407.1 409.8 406.6 404.6 403.7 397.6
0.1
White . . . . . . . . . . . . . . . . . . . . . . 421.3 423.2 430.0 422.3 424.8 421.2 419.1 417.2 412.0 0.0
Black or African American . . . . . . . . . . 406.5 403.2 404.0 410.1 416.2 406.0 411.6 406.8 389.9 0.0
American Indian or Alaska Native 3 . . . . . 316.5 338.6 366.2 336.1 389.0 378.3 364.1 370.2 365.7
0.6
Asian or Pacific Islander . . . . . . . . . . . 295.7 297.8 300.9 299.7 306.9 312.0 310.0 310.3 307.3
0.2
Hispanic or Latina 4 . . . . . . . . . . . . . . 322.7 310.5 317.9 318.0 326.3 318.4 327.6 321.9 322.7 0.1
White, not Hispanic or Latina 4 . . . . . . . . 430.7 436.7 446.0 439.9 442.4 440.8 437.8 436.3 431.5 0.1
Lung and bronchus
Male . . . . . . . . . . . . . . . . . . . . . . . . 95.0 86.9 77.8 75.5 71.5 63.1 60.8 58.8 55.9
2.1
White . . . . . . . . . . . . . . . . . . . . . . 94.1 85.0 76.3 74.3 70.8 62.8 60.3 58.0 55.1
2.1
Black or African American . . . . . . . . . . 134.2 137.0 111.7 112.1 98.0 82.2 82.7 81.6 74.1
2.6
American Indian or Alaska Native 3 . . . . . 77.3 82.8 62.6 74.2 67.4 67.1 55.6 45.2 53.2
1.2
Asian or Pacific Islander . . . . . . . . . . . 64.4 60.1 63.9 58.7 58.2 51.0 50.0 48.8 48.5
1.3
Hispanic or Latino 4 . . . . . . . . . . . . . . 59.4 52.4 45.2 46.5 43.9 34.5 35.6 33.9 33.8
2.1
White, not Hispanic or Latino 4 . . . . . . . . 97.4 88.4 80.2 77.9 74.6 67.2 64.2 62.0 58.8
1.9
Female . . . . . . . . . . . . . . . . . . . . . . . 47.2 49.3 48.6 49.8 50.0 46.1 44.9 44.4 43.2
0.4
White . . . . . . . . . . . . . . . . . . . . . . 48.5 51.7 50.7 52.4 51.9 48.1 46.6 46.1 45.1
0.3
Black or African American . . . . . . . . . . 52.9 50.0 55.1 55.5 58.4 52.9 50.0 52.0 48.1 0.1
American Indian or Alaska Native 3 . . . . . 30.4 46.1 38.5 41.4 45.5 37.2 42.1 34.6 27.5 0.5
Asian or Pacific Islander . . . . . . . . . . . 28.4 27.6 27.3 29.1 30.8 29.2 31.3 29.0 29.2
0.3
Hispanic or Latina 4 . . . . . . . . . . . . . . 26.2 25.2 24.3 24.4 22.9 24.8 23.8 22.8 24.5
0.4
White, not Hispanic or Latina 4 . . . . . . . . 50.8 54.8 54.4 56.6 56.4 52.0 50.8 50.3 49.1 0.1
Colon and rectum
Male . . . . . . . . . . . . . . . . . . . . . . . . 72.3 63.2 62.6 58.4 54.7 46.9 45.4 43.6 42.3
2.1
White . . . . . . . . . . . . . . . . . . . . . . 73.0 62.5 62.0 57.1 54.1 45.4 43.6 42.1 40.3
2.3
Black or African American . . . . . . . . . . 73.1 75.2 73.6 76.3 67.0 57.7 57.0 55.7 55.8
1.4
American Indian or Alaska Native 3 . . . . . 61.9 66.2 48.7 70.4 65.6 64.7 65.0 57.7 53.6 0.2
Asian or Pacific Islander . . . . . . . . . . . 60.9 58.8 58.0 53.3 47.7 45.5 45.6 42.3 42.5
1.6
Hispanic or Latino 4 . . . . . . . . . . . . . . 47.7 46.0 50.5 47.4 47.4 42.0 43.5 40.2 38.2
0.9
White, not Hispanic or Latino 4 . . . . . . . . 75.0 63.9 63.4 58.1 54.8 46.0 43.6 42.4 40.8
2.4
Female . . . . . . . . . . . . . . . . . . . . . . . 50.2 45.9 46.1 43.6 41.4 36.0 34.7 33.6 32.1
1.6
White . . . . . . . . . . . . . . . . . . . . . . 49.7 45.4 45.6 42.9 40.3 34.5 33.8 32.8 31.5
1.7
Black or African American . . . . . . . . . . 61.3 54.9 58.1 55.4 54.2 46.5 42.5 41.5 38.6
1.4
American Indian or Alaska Native 3 . . . . . 45.8 47.9 39.1 45.1 48.3 42.9 46.0 45.4 48.9 0.2
Asian or Pacific Islander . . . . . . . . . . . 37.8 38.9 37.5 36.4 36.9 34.6 31.6 28.8 27.5
1.4
Hispanic or Latina 4 . . . . . . . . . . . . . . 34.5 31.9 34.1 33.6 33.7 30.7 29.3 28.1 26.8
0.7
White, not Hispanic or Latina 4 . . . . . . . . 50.9 46.7 46.7 44.0 41.3 35.0 34.6 33.7 32.5
1.7
Prostate
Male . . . . . . . . . . . . . . . . . . . . . . . . 166.9 166.6 179.0 165.5 154.1 143.8 137.2 111.5 104.6
2.0
White . . . . . . . . . . . . . . . . . . . . . . 168.5 161.3 174.9 161.7 150.1 139.3 132.9 105.6 99.6
2.1
Black or African American . . . . . . . . . . 219.5 279.7 291.6 253.7 243.8 219.9 208.2 181.4 170.0
2.0
American Indian or Alaska Native 3 . . . . . 98.3 93.5 71.5 113.1 94.4 83.8 66.6 62.0 58.9
2.2
Asian or Pacific Islander . . . . . . . . . . . 88.6 104.7 108.1 105.2 95.8 79.2 79.6 63.9 56.7
2.1
Hispanic or Latino 4 . . . . . . . . . . . . . . 119.2 141.2 150.6 139.3 132.8 118.9 110.2 94.5 83.1
1.8
White, not Hispanic or Latino 4 . . . . . . . . 172.2 163.6 178.7 165.3 152.7 143.2 137.3 108.3 103.4
2.0
See footnotes at end of table.
19902013
Site, sex, race, and Hispanic origin 1990 1995 2000 2003 2005 2010 2011 2012 2013 APC 1
Female . . . . . . . . . . . . . . . . . . . . . . . 129.4 130.9 134.2 124.2 124.5 123.5 126.7 126.3 126.2
0.3
White . . . . . . . . . . . . . . . . . . . . . . 134.2 136.3 140.6 129.1 129.6 127.3 130.5 129.3 129.1
0.3
Black or African American . . . . . . . . . . 117.4 123.0 122.8 123.3 119.3 123.5 129.2 130.8 126.4
0.3
American Indian or Alaska Native 3 . . . . . 69.6 96.7 100.2 94.1 105.6 91.7 105.3 97.2 89.7 0.3
Asian or Pacific Islander . . . . . . . . . . . 88.1 88.4 94.9 92.2 95.7 100.7 102.7 104.3 107.4
0.7
Hispanic or Latina 4 . . . . . . . . . . . . . . 91.0 89.4 97.0 88.0 93.0 87.3 96.0 91.7 93.4 0.1
White, not Hispanic or Latina 4 . . . . . . . . 138.6 141.9 147.0 135.8 136.2 135.5 137.4 137.1 137.0 0.2
Cervix uteri
Female . . . . . . . . . . . . . . . . . . . . . . . 11.9 9.9 8.9 8.2 7.9 7.2 7.0 6.9 6.6
2.4
White . . . . . . . . . . . . . . . . . . . . . . 11.2 9.2 8.9 7.9 7.8 7.2 7.2 6.8 6.5
2.1
Black or African American . . . . . . . . . . 16.7 14.9 10.7 10.8 9.3 8.5 7.8 7.7 8.1
3.5
American Indian or Alaska Native 3 . . . . . 14.7 * * * 10.7 8.3 9.5 * 9.4
1.9
Asian or Pacific Islander . . . . . . . . . . . 12.2 11.2 8.0 8.1 7.8 6.5 5.4 6.7 5.7
3.8
Hispanic or Latina 4 . . . . . . . . . . . . . . 21.3 17.4 17.1 14.0 13.7 10.5 9.3 9.4 8.2
3.9
White, not Hispanic or Latina 4 . . . . . . . . 9.7 7.8 7.1 6.5 6.4 6.2 6.5 6.0 5.9
1.9
Corpus and uterus,
not otherwise specified
Female . . . . . . . . . . . . . . . . . . . . . . . 24.7 24.9 23.9 23.6 24.1 26.7 26.6 27.0 26.4
0.4
White . . . . . . . . . . . . . . . . . . . . . . 26.4 26.4 25.6 25.0 25.4 27.6 27.2 28.0 26.9
0.2
Black or African American . . . . . . . . . . 17.0 17.9 17.4 20.3 21.5 24.6 27.7 25.1 27.0
2.2
American Indian or Alaska Native 3 . . . . . 19.3 * 18.5 19.5 14.4 27.6 20.5 19.3 27.1 *
Asian or Pacific Islander . . . . . . . . . . . 13.5 17.8 16.6 16.6 18.9 22.5 21.7 22.3 22.4
1.8
Hispanic or Latina 4 . . . . . . . . . . . . . . 17.7 16.5 15.8 17.8 19.3 20.4 22.1 23.9 23.3
1.6
White, not Hispanic or Latina 4 . . . . . . . . 27.1 27.5 26.9 26.0 26.2 28.6 27.7 28.4 27.2 0.1
Ovary
Female . . . . . . . . . . . . . . . . . . . . . . . 15.6 14.6 14.2 13.6 13.2 12.5 12.2 12.3 11.4
1.1
White . . . . . . . . . . . . . . . . . . . . . . 16.4 15.4 15.0 14.3 13.9 13.4 12.9 13.0 11.9
1.1
Black or African American . . . . . . . . . . 11.3 10.8 10.9 11.6 10.8 9.6 10.0 10.6 8.8
0.5
American Indian or Alaska Native 3 . . . . . 21.9 * 18.9 13.4 12.2 11.9 11.6 15.7 10.9 *
Asian or Pacific Islander . . . . . . . . . . . 11.1 10.4 10.4 10.2 11.0 9.8 9.6 9.6 9.7
0.5
Hispanic or Latina 4 . . . . . . . . . . . . . . 12.2 11.7 10.6 11.6 11.8 11.8 11.2 12.2 10.0 0.4
White, not Hispanic or Latina 4 . . . . . . . . 16.8 15.9 15.6 14.7 14.1 13.4 13.1 13.0 12.1
1.1
Oral cavity and pharynx
Male . . . . . . . . . . . . . . . . . . . . . . . . 18.5 16.5 15.8 15.2 15.1 15.5 15.9 15.6 16.3
0.6
White . . . . . . . . . . . . . . . . . . . . . . 18.0 16.4 15.6 15.3 15.5 16.1 16.9 16.4 16.9 0.3
Black or African American . . . . . . . . . . 25.4 22.3 19.4 17.6 15.9 13.8 13.9 14.0 14.2
2.7
American Indian or Alaska Native 3 . . . . . * * * 16.3 10.4 21.3 16.0 15.4 12.8 *
Asian or Pacific Islander . . . . . . . . . . . 14.9 11.8 13.7 11.9 11.5 11.7 10.9 10.7 12.5
0.9
Hispanic or Latino 4 . . . . . . . . . . . . . . 10.7 12.3 9.1 8.8 9.8 8.9 10.8 10.0 8.9
0.6
White, not Hispanic or Latino 4 . . . . . . . . 18.8 16.9 16.6 16.3 16.4 17.5 18.1 17.6 18.5 0.0
Female . . . . . . . . . . . . . . . . . . . . . . . 7.3 7.0 6.2 6.0 6.1 6.1 6.1 6.3 6.1
0.8
White . . . . . . . . . . . . . . . . . . . . . . 7.4 7.1 6.2 5.9 6.0 6.3 6.3 6.5 6.3
0.7
Black or African American . . . . . . . . . . 6.4 6.7 5.4 6.7 6.9 5.4 5.2 4.5 5.2
1.5
American Indian or Alaska Native 3 . . . . . * * * * * * * 7.4 8.8 *
Asian or Pacific Islander . . . . . . . . . . . 6.1 5.2 6.3 5.1 5.9 5.2 4.8 5.9 5.2
0.8
Hispanic or Latina 4 . . . . . . . . . . . . . . 4.0 3.7 3.7 3.9 3.5 4.2 3.7 3.9 4.1 0.3
White, not Hispanic or Latina 4 . . . . . . . . 7.8 7.5 6.6 6.2 6.4 6.7 6.9 7.0 6.8
0.6
Stomach
Male . . . . . . . . . . . . . . . . . . . . . . . . 14.6 13.5 12.6 11.8 11.4 10.5 10.6 10.1 10.0
1.7
White . . . . . . . . . . . . . . . . . . . . . . 12.8 11.9 10.6 10.1 9.6 9.3 9.5 8.8 8.7
1.6
Black or African American . . . . . . . . . . 21.5 18.6 18.6 18.7 17.4 13.3 14.1 14.8 14.2
2.1
American Indian or Alaska Native 3 . . . . . * 24.1 20.2 * 20.8 20.7 21.2 16.1 22.8 0.3
Asian or Pacific Islander . . . . . . . . . . . 26.8 24.5 23.0 19.2 20.2 15.3 14.2 14.9 14.3
2.9
Hispanic or Latino 4 . . . . . . . . . . . . . . 20.2 19.3 16.1 16.2 15.5 14.9 14.2 13.0 12.1
1.9
White, not Hispanic or Latino 4 . . . . . . . . 12.1 11.1 10.0 9.2 8.7 8.3 8.5 7.9 7.8
1.9
See footnotes at end of table.
19902013
Site, sex, race, and Hispanic origin 1990 1995 2000 2003 2005 2010 2011 2012 2013 APC 1
Female . . . . . . . . . . . . . . . . . . . . . . . 6.7 6.2 6.1 6.0 5.7 5.7 5.6 5.9 5.4
0.8
White . . . . . . . . . . . . . . . . . . . . . . 5.7 5.1 5.0 5.0 4.7 4.7 4.8 5.0 4.5
0.8
Black or African American . . . . . . . . . . 10.0 9.8 8.7 9.5 8.1 8.5 9.4 8.1 6.9
1.2
American Indian or Alaska Native 3 . . . . . * * * * * 13.0 * 12.1 12.3 *
Asian or Pacific Islander . . . . . . . . . . . 15.4 13.0 12.9 11.1 10.3 8.9 7.8 8.8 8.8
2.7
Hispanic or Latina 4 . . . . . . . . . . . . . . 10.8 11.2 10.6 10.3 10.2 9.4 8.8 9.6 8.8
1.0
White, not Hispanic or Latina 4 . . . . . . . . 5.1 4.5 4.2 4.1 3.8 3.6 3.9 3.9 3.5
1.5
Pancreas
Male . . . . . . . . . . . . . . . . . . . . . . . . 13.0 12.8 12.8 12.5 13.7 13.7 14.2 14.0 14.1
0.6
White . . . . . . . . . . . . . . . . . . . . . . 12.7 12.4 12.6 12.3 13.4 13.5 14.2 14.5 14.0
0.7
Black or African American . . . . . . . . . . 19.3 19.1 18.2 17.4 18.3 18.6 17.0 16.1 17.8 0.3
American Indian or Alaska Native 3 . . . . . * * * * 21.2 17.4 17.7 * 13.0 *
Asian or Pacific Islander . . . . . . . . . . . 11.0 10.3 10.7 10.2 11.8 11.4 12.2 10.3 12.1 0.2
Hispanic or Latino 4 . . . . . . . . . . . . . . 10.7 12.0 12.2 10.1 12.3 11.5 13.4 10.7 11.8
0.7
White, not Hispanic or Latino 4 . . . . . . . . 12.8 12.4 12.7 12.7 13.6 13.8 14.3 15.0 14.3
0.7
Female . . . . . . . . . . . . . . . . . . . . . . . 10.0 9.9 9.9 10.4 10.8 11.2 10.6 11.3 11.0
0.6
White . . . . . . . . . . . . . . . . . . . . . . 9.7 9.6 9.6 10.2 10.6 10.9 10.4 11.0 11.0
0.7
Black or African American . . . . . . . . . . 12.9 15.5 12.8 14.4 16.4 15.1 15.1 15.1 13.3 0.1
American Indian or Alaska Native 3 . . . . . * * 20.4 * 12.4 12.9 * 12.1 * *
Asian or Pacific Islander . . . . . . . . . . . 9.9 8.1 9.2 8.1 8.0 10.5 9.1 10.3 9.4
1.0
Hispanic or Latina 4 . . . . . . . . . . . . . . 9.9 9.0 9.1 8.6 11.1 9.9 10.2 10.4 11.2 0.3
White, not Hispanic or Latina 4 . . . . . . . . 9.7 9.7 9.6 10.5 10.6 11.1 10.4 11.1 10.9
0.7
Urinary bladder
Male . . . . . . . . . . . . . . . . . . . . . . . . 37.2 35.4 36.8 37.0 37.0 35.9 33.9 34.2 32.7
0.3
White . . . . . . . . . . . . . . . . . . . . . . 40.7 38.8 40.8 40.8 40.9 40.0 38.1 38.0 36.2
0.2
Black or African American . . . . . . . . . . 19.7 19.7 20.2 23.2 23.2 22.2 20.7 23.3 22.6
0.5
American Indian or Alaska Native 3 . . . . . * * * * 16.8 17.4 17.7 * 13.7 *
Asian or Pacific Islander . . . . . . . . . . . 15.4 17.2 16.9 18.1 17.5 17.3 14.9 16.4 15.5 0.2
Hispanic or Latino 4 . . . . . . . . . . . . . . 22.4 17.8 20.4 20.2 20.2 18.5 19.9 18.8 18.1 0.4
White, not Hispanic or Latino 4 . . . . . . . . 42.4 40.9 43.2 43.4 43.6 43.2 41.0 41.0 39.3 0.1
Female . . . . . . . . . . . . . . . . . . . . . . . 9.5 9.3 9.1 9.2 9.0 8.6 8.3 8.3 7.8
0.6
White . . . . . . . . . . . . . . . . . . . . . . 10.0 10.1 10.0 10.0 9.7 9.4 9.1 9.3 8.5
0.5
Black or African American . . . . . . . . . . 8.7 7.3 7.8 7.8 7.9 7.0 7.1 6.0 7.7 0.5
American Indian or Alaska Native 3 . . . . . * * * * * * * * * *
Asian or Pacific Islander . . . . . . . . . . . 5.2 4.5 4.3 5.0 5.2 4.7 4.4 4.1 3.8 0.3
Hispanic or Latina 4 . . . . . . . . . . . . . . 5.8 5.3 5.8 4.7 5.9 4.7 5.6 4.8 4.4
0.6
White, not Hispanic or Latina 4 . . . . . . . . 10.3 10.6 10.5 10.8 10.3 10.2 9.8 10.1 9.3
0.3
Non-Hodgkin lymphoma
Male . . . . . . . . . . . . . . . . . . . . . . . . 22.6 25.1 23.6 24.3 24.7 25.4 23.7 23.6 23.6 0.1
White . . . . . . . . . . . . . . . . . . . . . . 23.6 26.2 25.0 25.7 25.9 26.6 25.0 24.9 24.7
0.2
Black or African American . . . . . . . . . . 17.7 21.7 17.6 19.4 19.6 21.4 17.4 17.4 17.6 0.1
American Indian or Alaska Native 3 . . . . . * * 15.3 * 23.2 19.6 10.8 13.8 10.4 *
Asian or Pacific Islander . . . . . . . . . . . 16.7 16.5 16.4 16.4 17.9 17.5 18.1 17.6 17.9 0.3
Hispanic or Latino 4 . . . . . . . . . . . . . . 17.3 21.0 20.5 19.5 19.9 22.8 19.9 19.4 19.6 0.3
White, not Hispanic or Latino 4 . . . . . . . . 24.3 26.7 25.5 26.5 27.0 27.2 25.7 25.9 25.7
0.3
Female . . . . . . . . . . . . . . . . . . . . . . . 14.5 15.2 16.0 17.2 16.5 17.0 15.8 16.1 15.6
0.5
White . . . . . . . . . . . . . . . . . . . . . . 15.4 15.9 16.9 18.0 17.7 18.1 16.6 17.1 16.5
0.6
Black or African American . . . . . . . . . . 10.4 10.3 11.9 13.5 13.3 12.7 12.9 13.6 12.8
1.2
American Indian or Alaska Native 3 . . . . . * * 13.5 * 12.2 13.0 16.5 11.1 12.8 *
Asian or Pacific Islander . . . . . . . . . . . 9.5 12.2 11.5 12.7 9.7 11.9 12.0 11.4 10.8 0.4
Hispanic or Latina 4 . . . . . . . . . . . . . . 13.6 13.1 13.8 15.3 15.0 15.5 14.6 15.2 14.5
0.7
White, not Hispanic or Latina 4 . . . . . . . . 15.6 16.2 17.3 18.4 18.1 18.4 17.0 17.2 16.9
0.6
See footnotes at end of table.
19902013
Site, sex, race, and Hispanic origin 1990 1995 2000 2003 2005 2010 2011 2012 2013 APC 1
Male . . . . . . . . . . . . . . . . . . . . . . . . 17.2 17.7 17.2 17.4 17.5 18.1 17.7 17.3 16.8 0.1
White . . . . . . . . . . . . . . . . . . . . . . 18.0 19.0 18.2 18.5 19.1 19.6 19.0 18.2 18.1
0.2
Black or African American . . . . . . . . . . 16.2 13.4 14.3 15.1 12.9 13.7 14.3 14.9 14.0 0.1
American Indian or Alaska Native 3 . . . . . * * * * 12.3 * 9.8 14.6 11.4 *
Asian or Pacific Islander . . . . . . . . . . . 8.4 10.2 10.6 10.5 9.4 10.1 10.4 10.5 8.7 0.1
Hispanic or Latino 4 . . . . . . . . . . . . . . 12.2 14.6 13.3 12.3 13.2 13.2 13.8 11.5 12.7 0.3
White, not Hispanic or Latino 4 . . . . . . . . 18.3 19.3 18.7 19.1 19.5 20.1 19.6 19.0 18.6
0.2
Female . . . . . . . . . . . . . . . . . . . . . . . 9.9 10.3 10.4 10.1 10.1 10.7 10.5 10.6 10.3
0.3
White . . . . . . . . . . . . . . . . . . . . . . 10.3 10.9 11.0 10.7 10.7 11.5 11.4 11.3 11.2
0.4
Black or African American . . . . . . . . . . 8.5 8.4 9.8 9.1 9.6 9.1 9.4 9.2 8.4 0.1
American Indian or Alaska Native 3 . . . . . * * * * * 8.7 * 7.0 8.1 *
Asian or Pacific Islander . . . . . . . . . . . 5.7 6.4 6.4 6.5 6.4 6.1 6.4 6.6 6.2 0.0
Hispanic or Latina 4 . . . . . . . . . . . . . . 8.5 8.2 7.8 7.2 8.3 8.7 8.7 8.8 9.6
0.6
White, not Hispanic or Latina 4 . . . . . . . . 10.3 11.1 11.1 11.2 10.7 11.8 11.6 11.4 11.2
0.5
Annual percent change (APC) is significantly different from zero (p < 0.05).
0.0 APC is greater than 0.05 but less than 0.05.
* Estimates are considered unreliable. Data not shown if the rate is based on fewer than 16 cases for the time interval. The trend is not shown if it is based on fewer than
10 cases for at least 1 year within the time interval.
1
APC was calculated by fitting a linear regression model to the natural logarithm of the yearly rates from 19902013.
2
Age-adjusted by 5-year age groups to the year 2000 U.S. standard population. Age-adjusted rates are based on at least 16 cases. See Appendix II, Age adjustment.
3
Estimates for the American Indian or Alaska Native populations are based on the Contract Health Service Delivery Area (CHSDA) counties within SEER areas.
4
Hispanic data exclude cases from Alaska. The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of
Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. The North American Association of Central Cancer Registries (NAACCR) Hispanic
Identification Algorithm was used on a combination of variables to classify cases as Hispanic for analytic purposes. See the report, NAACCR guideline for enhancing
Hispanic-Latino identification, for more information. Available from: http://seer.cancer.gov/seerstat/variables/seer/yr1973_2006/race_ethnicity/. See Appendix II,
Hispanic origin.
NOTES: See Appendix II, Incidence. Estimates are based on 13 SEER areas (November 2015 submission) and differ from published estimates based on 9 SEER
areas or other submission dates. See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER). The site variable distinguishes Kaposi Sarcoma and
Mesothelioma as individual cancer sites. As a result, Kaposi Sarcoma and Mesothelioma cases do not contribute to other cancer sites. Estimates for 20012009 were
computed using intercensal population estimates based on the 2000 and 2010 censuses. Data have been revised and differ from previous editions of Health, United
States. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Available from:
http://www.seer.cancer.gov. See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER).
1975 1981 1987 1999 2006 1975 1981 1987 1999 2006
Sex and site 1977 1983 1989 2001 2012 1977 1983 1989 2001 2012
* Data for population groups with fewer than 25 cases are not shown because estimates are considered unreliable.
NOTES: Rates are based on follow-up of patients through 2013. The rate is the ratio of the observed survival rate for the patient group to the expected survival rate
for persons in the general population similar to the patient group with respect to age, sex, race, and calendar year of observation. It estimates the chance of surviving
the effects of cancer. See Appendix II, Relative survival rate. The site variable distinguishes Kaposi Sarcoma and Mesothelioma as individual cancer sites. As a result,
Kaposi Sarcoma and Mesothelioma cases are excluded from each of the sites shown except all sites combined. The race groups, white and black, include persons of
Hispanic and non-Hispanic origin. Due to death certificate race-ethnicity classification and other methodological issues related to developing life tables, relative survival
rates for race-ethnicity groups other than white and black are not calculated. Data have been revised and differ from previous editions of Health, United States. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Available from: http://www.seer.cancer.gov.
See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER).
Percent of adults
18 years and over, age-adjusted 4,5 . . . . 12.0 11.1 11.1 10.7 4.9 5.1 6.0 5.9 2.3 2.2 2.6 2.4
18 years and over, crude 5 . . . . . . . . . 11.6 10.9 11.6 11.6 4.8 4.9 6.3 6.5 2.2 2.1 2.7 2.7
Age
1844 years . . . . . . . . . . . . . . . . 4.6 4.3 4.0 4.3 1.7 1.7 1.7 1.6 0.4 0.4 0.6 0.5
1824 years . . . . . . . . . . . . . . . 3.2 3.3 3.0 3.3 0.8 1.0 0.7 *0.5 * * * *
2544 years . . . . . . . . . . . . . . . 5.0 4.6 4.4 4.7 2.0 1.9 2.0 2.0 0.4 0.5 0.7 0.7
4564 years . . . . . . . . . . . . . . . . 13.5 12.6 13.0 11.9 5.4 5.2 6.9 6.6 2.3 2.0 2.9 2.8
4554 years . . . . . . . . . . . . . . . 10.9 10.0 9.6 8.5 4.0 4.0 4.9 4.2 1.4 1.3 2.1 1.8
5564 years . . . . . . . . . . . . . . . 17.4 16.6 17.1 15.5 7.4 7.2 9.3 9.1 3.8 3.1 3.9 3.9
65 years and over . . . . . . . . . . . . . 31.8 29.6 30.5 29.2 14.1 15.2 18.5 18.4 8.1 8.1 8.2 7.5
6574 years . . . . . . . . . . . . . . . 27.8 25.8 25.6 25.3 12.4 13.1 15.9 15.0 6.7 6.2 6.3 5.5
75 years and over. . . . . . . . . . . . 37.0 34.3 36.5 34.8 16.2 17.7 21.7 23.2 9.8 10.3 10.6 10.5
Sex 4
Male . . . . . . . . . . . . . . . . . . . . . . 12.3 11.9 12.4 11.9 4.1 4.4 5.5 5.3 2.6 2.4 2.6 2.5
Female. . . . . . . . . . . . . . . . . . . 11.8 10.5 10.2 9.8 5.8 5.8 6.6 6.5 2.1 2.1 2.6 2.3
Sex and age
Male:
1844 years . . . . . . . . . . . . . . . 3.7 3.6 3.7 4.2 0.8 0.8 0.9 0.9 0.3 0.3 0.5 0.5
4554 years . . . . . . . . . . . . . . . 11.0 10.0 9.5 8.4 2.0 2.0 3.1 2.7 1.2 1.3 1.9 1.7
5564 years . . . . . . . . . . . . . . . 18.7 19.7 19.1 17.4 5.8 5.9 7.5 7.4 4.6 3.7 4.0 4.1
6574 years . . . . . . . . . . . . . . . 32.0 30.4 31.3 31.2 12.8 13.9 16.9 14.6 8.1 6.7 6.6 6.6
75 years and over. . . . . . . . . . . . 40.8 39.2 44.7 41.5 18.3 20.3 26.1 26.1 11.2 11.3 10.6 10.6
Female:
1844 years . . . . . . . . . . . . . . . 5.5 4.9 4.3 4.4 2.6 2.5 2.5 2.2 0.4 0.4 0.6 0.6
4554 years . . . . . . . . . . . . . . . 10.8 9.9 9.6 8.6 6.0 5.9 6.6 5.6 1.5 1.4 2.2 1.9
5564 years . . . . . . . . . . . . . . . 16.2 13.8 15.3 13.9 8.8 8.4 10.9 10.6 3.2 2.6 3.9 3.8
6574 years . . . . . . . . . . . . . . . 24.5 22.0 20.6 20.2 12.1 12.5 15.0 15.3 5.5 5.8 6.1 4.6
75 years and over. . . . . . . . . . . . 34.6 31.2 30.9 30.1 14.9 16.1 18.7 21.2 9.0 9.6 10.6 10.3
Race 4,6
White only . . . . . . . . . . . . . . . . . 12.2 11.3 11.2 11.0 5.2 5.4 6.3 6.3 2.2 2.1 2.3 2.3
Black or African American only . . . . . . 11.4 10.6 10.7 9.7 3.5 3.5 5.1 4.5 3.3 3.5 4.1 3.8
American Indian or Alaska Native only . . 18.6 14.7 12.5 13.4 *6.5 *5.7 6.5 5.3 *5.0 *5.4 *4.7 *2.6
Asian only . . . . . . . . . . . . . . . . . 6.9 6.3 7.2 6.5 2.4 *2.3 3.0 2.9 *1.2 *1.2 2.4 1.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . -- 17.0 16.7 16.5 -- *4.7 7.9 6.0 -- *4.0 *3.9 3.7
Hispanic origin and race 4,6
Hispanic or Latino . . . . . . . . . . . . . 8.7 8.0 8.4 8.0 2.9 3.0 3.4 3.9 2.1 1.9 2.7 2.4
Mexican . . . . . . . . . . . . . . . . . 7.5 7.4 8.4 7.7 3.0 2.8 3.2 3.7 2.5 2.0 2.6 2.7
Not Hispanic or Latino. . . . . . . . . . . 12.2 11.4 11.4 11.1 5.1 5.2 6.3 6.1 2.3 2.2 2.6 2.4
White only. . . . . . . . . . . . . . . . 12.5 11.6 11.7 11.5 5.4 5.5 6.7 6.6 2.2 2.1 2.3 2.3
Black or African American only . . . . . 11.4 10.5 10.8 9.8 3.6 3.6 5.1 4.4 3.3 3.5 4.2 3.9
Education 7,8
No high school diploma or GED. . . . . . 15.1 13.8 14.6 13.8 5.3 5.5 5.8 5.8 3.9 3.8 4.4 4.1
High school diploma or GED . . . . . . . 12.8 11.9 12.4 12.0 5.5 5.8 6.8 6.8 2.5 2.5 3.4 3.1
Some college or more . . . . . . . . . . . 12.7 12.0 11.9 11.5 6.0 5.9 7.4 7.1 2.1 1.9 2.3 2.2
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Heart disease is based on self-reported responses to questions about whether respondents had ever been told by a doctor or other health professional that they had
coronary heart disease, angina (angina pectoris), a heart attack (myocardial infarction), or any other kind of heart disease or heart condition.
2
Cancer is based on self-reported responses to a question about whether respondents had ever been told by a doctor or other health professional that they had cancer
or a malignancy of any kind. Excludes squamous cell and basal cell carcinomas.
3
Stroke is based on self-reported responses to a question about whether respondents had ever been told by a doctor or other health professional that they had a
stroke.
4
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
5
Includes all other races not shown separately and unknown education level.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
7
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 2544 years, 4554 years, 5564 years,
6574 years, and 75 years and over. See Appendix II, Age adjustment.
8
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
9
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 19971998 and beyond. See Appendix II, Family income; Poverty; Table VI.
10
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Percent distribution
Total, age-adjusted 2,3 . . . . . . . . . . . 78.5 75.4 76.7 76.7 17.9 19.9 19.0 18.8 3.6 4.6 4.3 4.5
Total, crude 2. . . . . . . . . . . . . . . . 78.5 74.0 74.5 74.1 17.9 21.1 20.8 20.7 3.6 4.9 4.7 5.1
Age
1864 years . . . . . . . . . . . . . . . . 85.1 81.3 82.4 82.6 12.9 16.0 14.9 14.7 2.0 2.8 2.6 2.7
1844 years . . . . . . . . . . . . . . . . 93.3 92.2 93.2 92.8 6.2 7.2 6.3 6.7 0.5 0.6 0.4 0.5
1824 years . . . . . . . . . . . . . . . 96.4 96.6 97.1 97.2 3.5 3.3 2.8 2.8 * * * *
2544 years . . . . . . . . . . . . . . . 92.3 90.7 91.8 91.3 7.1 8.6 7.6 8.1 0.7 0.8 0.6 0.7
4564 years . . . . . . . . . . . . . . . . 71.4 66.2 67.7 68.8 24.2 28.1 26.6 25.5 4.4 5.7 5.6 5.7
4554 years . . . . . . . . . . . . . . . 78.4 74.1 76.2 77.3 18.6 22.3 20.1 19.3 3.1 3.6 3.7 3.3
5564 years . . . . . . . . . . . . . . . 60.9 56.4 58.4 59.8 32.7 35.3 33.8 32.0 6.4 8.3 7.8 8.2
65 years and over . . . . . . . . . . . . . 44.6 37.9 39.1 38.4 43.4 46.5 46.8 46.3 12.0 15.6 14.1 15.3
6574 years . . . . . . . . . . . . . . . 47.6 41.2 42.6 42.5 41.4 45.5 45.2 44.4 11.0 13.2 12.2 13.1
75 years and over. . . . . . . . . . . . 41.1 33.8 34.4 32.4 45.8 47.7 48.9 49.0 13.2 18.6 16.7 18.5
Sex 3
Male . . . . . . . . . . . . . . . . . . . . 79.7 76.2 77.6 77.4 16.5 19.3 18.2 18.1 3.8 4.5 4.3 4.6
Female. . . . . . . . . . . . . . . . . . . 77.3 74.7 75.9 76.1 19.1 20.5 19.8 19.4 3.6 4.8 4.3 4.5
Race 3,4
White only . . . . . . . . . . . . . . . . . 78.8 76.0 76.9 77.1 17.7 19.5 19.0 18.5 3.5 4.5 4.1 4.4
Black or African American only . . . . . . 74.3 70.4 72.9 71.9 21.3 23.8 21.4 22.5 4.4 5.8 5.7 5.6
American Indian or Alaska Native only . . 69.5 64.7 71.4 71.5 25.5 28.8 21.4 20.1 * * *7.2 *8.4
Asian only . . . . . . . . . . . . . . . . . 86.5 82.9 84.6 83.5 11.3 14.4 12.8 14.7 * 2.8 2.7 *1.8
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . * * * * * * * * * * * *
2 or more races . . . . . . . . . . . . . . 72.3 66.6 70.3 72.5 20.2 23.2 21.4 17.1 *7.6 *10.2 8.3 10.4
Hispanic origin and race 3,4
Hispanic or Latino . . . . . . . . . . . . . 82.2 78.0 80.0 79.7 14.8 17.9 16.1 16.2 3.0 4.1 3.9 4.1
Mexican . . . . . . . . . . . . . . . . . 81.8 77.7 80.0 79.2 15.0 18.0 15.9 16.3 3.2 4.3 4.1 4.5
Not Hispanic or Latino. . . . . . . . . . . 78.0 75.1 76.2 76.3 18.3 20.2 19.5 19.2 3.7 4.7 4.3 4.6
White only. . . . . . . . . . . . . . . . 78.3 75.6 76.2 76.4 18.1 19.8 19.6 19.1 3.6 4.5 4.2 4.5
Black or African American only . . . . . 74.3 70.1 72.6 71.9 21.3 24.0 21.7 22.6 4.4 5.8 5.7 5.5
Percent of poverty level 3,5
Below 100% . . . . . . . . . . . . . . . . 71.9 69.2 69.7 68.1 21.3 22.7 21.9 23.3 6.8 8.1 8.4 8.6
100%199%. . . . . . . . . . . . . . . . 76.4 72.6 73.6 73.3 18.6 21.0 20.7 20.6 5.0 6.4 5.7 6.1
200%399%. . . . . . . . . . . . . . . . 77.8 75.6 76.9 76.6 18.9 19.9 18.9 18.9 3.3 4.5 4.2 4.5
400% or more . . . . . . . . . . . . . . . 81.2 78.3 80.0 80.5 15.9 18.7 17.5 16.6 2.8 3.0 2.5 2.9
Health insurance status
at the time of interview 6,7
1864 years:
Insured . . . . . . . . . . . . . . . . . 85.1 82.5 84.1 84.4 13.0 15.0 13.5 13.4 1.9 2.5 2.4 2.3
Private . . . . . . . . . . . . . . . . 86.9 84.9 87.0 87.3 11.8 13.6 11.7 11.4 1.2 1.5 1.3 1.3
Medicaid . . . . . . . . . . . . . . . 69.2 69.6 71.4 71.9 22.3 22.3 20.8 21.1 8.5 8.1 7.8 6.9
Uninsured . . . . . . . . . . . . . . . . 87.5 85.9 86.6 88.0 10.7 12.4 12.0 10.4 1.8 1.7 1.4 1.5
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Adults were categorized as having 01, 23, or 4 or more of the following chronic conditions: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis,
hepatitis, weak or failing kidneys, chronic obstructive pulmonary disease, or current asthma. Data from the National Health Interview Survey capture 10 of 20
chronic conditions used in a standardized approach for defining chronic conditions in the United States. Thus, these estimates are conservative in nature. For more
information, see: Goodman RA, Posner SF, Huang ES, Parekh AK, Koh HK. Defining and measuring chronic conditions: imperatives for research, policy, program,
and practice. Prev Chronic Dis 2013;10:120239. Available from: http://www.cdc.gov/pcd/issues/2013/12_0239.htm, and Ward BW, Schiller JS. Prevalence of multiple
chronic conditions among US adults: estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10:120203. Available from:
http://www.cdc.gov/pcd/issues/2013/12_0203.htm.
2
Includes all other races not shown separately and unknown health insurance status.
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
See Appendix II, Age adjustment.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Race-specific estimates are tabulated according to the 1997 Revisions to the Standards
for the Classification of Federal Data on Race and Ethnicity. The five single-race categories plus multiple-race categories shown in the table conform to the 1997
Standards. Race-specific estimates are for persons who reported only one racial group; the category 2 or more races includes persons who reported more than one
racial group. Starting with 2003 data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the
only race responses. Almost all persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed. See Appendix II, Family income; Poverty; Table VI.
6
Estimates are age-adjusted to the year 2000 standard population using three age groups: 1844 years, 4554 years, and 5564 years. See Appendix II, Age
adjustment.
7
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. State-
sponsored health plan coverage is included as Medicaid coverage. Coverage by the Children's Health Insurance Program (CHIP) is included with Medicaid coverage.
In addition to private and Medicaid, the insured category also includes military plans, other government-sponsored health plans, and Medicare, not shown separately.
Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans
are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See
Appendix II, Health insurance coverage.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. See http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the
Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Physician-diagnosed and
undiagnosed diabetes 1,2 Physician-diagnosed diabetes 1 Undiagnosed diabetes 2
Sex, age, and race 1988 1999 2007 2011 1988 1999 2007 2011 1988 1999 2007 2011
and Hispanic origin 3 1994 2002 2010 2014 1994 2002 2010 2014 1994 2002 2010 2014
Poor glycemic control (A1c greater than 9%) among persons with physician-diagnosed diabetes
Sex, age, and race
and Hispanic origin 3 19881994 19992002 20072010 20112014
1
Physician-diagnosed diabetes was obtained by self-report and excludes women who were pregnant.
2
Undiagnosed diabetes is defined as a fasting plasma glucose (FPG) of at least 126 mg/dL or a hemoglobin A1c of at least 6.5% and no reported physician diagnosis.
Respondents had fasted for at least 8 hours and less than 24 hours. Pregnant females are excluded. Estimates in some prior editions of Health, United States included
data from respondents who had fasted for at least 9 hours and less than 24 hours. Starting in 20052006, testing was performed at a different laboratory and using
different instruments than testing in earlier years. The National Health and Nutrition Examination Survey (NHANES) conducted crossover studies to evaluate the impact
of these changes on FPG and A1c measurements and recommended adjustments to the FPG data. The adjustments recommended by NHANES were incorporated
into the data presented here. For more information, see http://wwwn.cdc.gov/nchs/nhanes/2005-2006/GLU_D.htm. Prior to Health, United States, 2010, the definition of
undiagnosed diabetes did not consider hemoglobin A1c. The revised definition of undiagnosed diabetes was based on recommendations from the American Diabetes
Association. For more information, see Standards of medical care in diabetes2010. Diabetes Care 2010;33(suppl 1):S11-S61. To ensure data comparability, the
revised definition of undiagnosed diabetes was applied to all data in this table. Also see Appendix II, Diabetes.
3
Persons of Hispanic and Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to
the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The non-Hispanic race
categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group.
Prior to data year 1999, estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
4
Estimates are age-adjusted to the year 2000 standard population using three age groups: 2044 years, 4564 years, and 65 years and over. Age-adjusted estimates in
this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the adjustment procedure.
See Appendix II, Age adjustment.
5
Includes persons of all other races and Hispanic origins not shown separately.
6
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (6% in 20112014). See Appendix II, Family income; Poverty.
NOTES: Excludes pregnant women. Fasting weights were used to obtain estimates of total, physician-diagnosed, and undiagnosed diabetes prevalence. Examination
weights were used to obtain the poor glycemic control estimates. Estimates in this table may differ from other estimates based on the same data and presented
elsewhere if different weights, age adjustment groups, definitions, or trend adjustments are used. Standard errors are available in the spreadsheet version of this table.
Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015
Percent of poverty level 2,7 Percent of adults with pain during past 3 months
Below 100% . . . . . . . . . . . . . . . . . . . . . 23.3 22.7 21.8 35.4 34.9 36.8 18.6 20.2 19.9
100%199%. . . . . . . . . . . . . . . . . . . . . 18.9 19.5 19.0 30.8 32.5 33.8 16.1 17.7 18.3
200%399%. . . . . . . . . . . . . . . . . . . . . 15.5 16.6 15.5 27.9 28.5 28.7 14.8 15.2 14.9
400% or more . . . . . . . . . . . . . . . . . . . . 12.4 13.3 11.9 24.8 24.7 25.1 12.8 13.1 14.3
Hispanic origin and race and
percent of poverty level 2,4,7
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . 18.9 19.6 19.9 29.5 29.0 33.4 16.4 17.4 17.8
100%199% . . . . . . . . . . . . . . . . . . . 15.7 15.1 14.2 26.8 27.2 25.9 12.9 15.7 15.9
200%399% . . . . . . . . . . . . . . . . . . . 14.0 16.5 13.6 25.0 27.5 25.0 13.8 12.9 11.4
400% or more . . . . . . . . . . . . . . . . . . 13.0 14.0 12.9 21.6 25.6 27.5 12.1 15.3 12.0
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . 26.1 24.8 25.5 38.9 40.5 42.0 20.5 23.7 23.6
100%199% . . . . . . . . . . . . . . . . . . 20.4 22.0 22.8 33.3 35.9 38.6 18.0 19.9 21.5
200%399% . . . . . . . . . . . . . . . . . . 16.3 16.9 16.4 29.1 30.5 30.9 15.9 16.8 16.8
400% or more . . . . . . . . . . . . . . . . . 12.5 13.8 11.8 25.4 25.2 25.9 13.1 13.6 15.1
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . 22.7 24.0 19.8 34.5 32.5 33.1 17.9 18.6 17.3
100%199% . . . . . . . . . . . . . . . . . . 17.6 19.6 16.4 27.7 31.2 33.7 14.0 14.4 15.1
200%399% . . . . . . . . . . . . . . . . . . 14.0 17.6 15.7 24.3 23.7 24.9 10.2 11.7 12.0
400% or more . . . . . . . . . . . . . . . . . 12.9 12.2 13.6 21.5 21.0 22.2 11.9 8.5 11.8
Disability measure 2,8
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . . 29.3 30.1 29.5 48.0 49.5 51.7 27.2 28.1 30.1
Any basic actions difficulty . . . . . . . . . . . . 30.0 30.9 30.4 49.3 51.1 53.0 27.9 29.0 30.7
Any complex activity limitation . . . . . . . . . . 34.6 36.0 34.6 55.1 54.5 57.5 33.1 34.3 37.1
No disability . . . . . . . . . . . . . . . . . . . . . 11.0 11.7 10.6 19.4 19.0 19.4 9.1 9.7 9.7
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . 14.5 15.4 14.6 27.1 28.0 28.8 14.0 14.9 15.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . 15.6 16.8 15.9 28.7 28.1 29.0 15.3 16.0 14.9
South . . . . . . . . . . . . . . . . . . . . . . . . 17.1 18.2 15.8 27.5 28.3 28.6 13.9 14.6 14.9
West . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 15.1 15.2 30.0 29.3 29.9 16.1 16.5 17.5
Location of residence 2,9
Within MSA . . . . . . . . . . . . . . . . . . . . . 15.2 16.3 15.1 27.0 27.5 28.2 14.2 14.9 15.3
Outside MSA . . . . . . . . . . . . . . . . . . . . 18.1 18.6 17.9 32.5 33.8 34.5 16.4 18.1 18.2
See footnotes at end of table.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2000 2010 1 2015 1 1997 2000 2010 1 2015 1 1997 2000 2010 1 2015 1
Number, in millions
At least one basic actions difficulty or
complex activity limitation 2,3 . . . . . . . . . . . 60.9 59.0 73.7 77.0 41.3 39.3 50.7 50.5 19.6 19.7 23.0 26.5
At least one basic actions difficulty 2 . . . . . . 56.7 55.2 69.2 72.6 38.1 36.4 47.2 47.1 18.6 18.7 22.0 25.4
At least one complex activity limitation 3 . . . . 29.0 27.2 35.0 38.6 18.1 16.7 22.9 24.2 11.0 10.5 12.1 14.4
At least one basic actions difficulty or complex activity limitation 2,3
Percent
Total, age-adjusted 4,5 . . . . . . . . . . . . . . . 32.5 29.9 31.9 31.5 ... ... ... ... ... ... ... ...
Total, crude 4. . . . . . . . . . . . . . . . . . . . 31.8 29.5 32.8 33.2 25.8 23.5 27.1 26.9 62.2 60.8 61.7 59.8
At least one basic actions difficulty 2
Percent
Total, age-adjusted 4,5 . . . . . . . . . . . . . . . 30.1 27.9 29.9 29.6 ... ... ... ... ... ... ... ...
Total, crude 4. . . . . . . . . . . . . . . . . . . . 29.4 27.5 30.8 31.2 23.6 21.7 25.1 25.1 58.8 58.1 59.3 57.5
Sex
Male 25.6 23.8 26.3 26.6 20.7 18.9 21.4 21.1 54.5 53.4 53.8 52.0
Female . . . . . . . . . . . . . . . . . . . . . . 32.9 31.0 35.1 35.6 26.4 24.3 28.8 28.8 61.9 61.5 63.6 61.9
Race 6
White only . . . . . . . . . . . . . . . . . . . . . 29.6 28.1 31.2 31.6 23.5 21.8 25.1 25.1 58.5 58.0 59.2 57.2
Black or African American only . . . . . . . . . . 31.4 27.2 32.3 33.5 26.9 22.7 28.4 28.8 64.4 60.6 62.9 62.4
American Indian or Alaska Native only . . . . . . 43.8 36.8 41.6 41.2 41.9 34.1 38.5 37.6 66.0 70.2 74.0 65.4
Asian only . . . . . . . . . . . . . . . . . . . . . 15.5 15.5 17.5 19.3 13.0 12.6 12.8 14.8 46.4 44.7 50.1 47.0
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . . -- 38.0 36.3 33.5 -- 34.4 33.9 27.6 -- 70.7 65.4 74.4
Hispanic origin and race 6
Hispanic or Latino . . . . . . . . . . . . . . . . . 23.8 19.6 24.7 24.1 21.0 16.6 21.2 20.5 54.6 57.5 61.5 57.1
Not Hispanic or Latino. . . . . . . . . . . . . . . 30.0 28.5 31.8 32.6 23.9 22.4 25.9 26.0 59.0 58.2 59.1 57.5
White only. . . . . . . . . . . . . . . . . . . . 30.3 29.1 32.4 33.4 23.8 22.5 26.0 26.4 58.7 58.2 59.0 57.2
Black or African American only . . . . . . . . . 31.5 27.3 32.6 33.8 27.0 22.9 28.6 29.0 64.4 60.4 63.2 62.6
Percent of poverty level 7
Below 100% . . . . . . . . . . . . . . . . . . . . 41.9 38.4 40.6 42.8 36.2 31.9 36.3 37.8 74.1 71.6 72.7 76.8
100%199%. . . . . . . . . . . . . . . . . . . . 38.2 37.1 38.7 41.0 29.2 26.5 30.5 33.3 66.6 69.4 69.5 69.0
200%399%. . . . . . . . . . . . . . . . . . . . 28.4 28.2 31.1 32.4 22.0 22.1 24.1 24.6 56.1 53.9 58.9 60.5
400% or more . . . . . . . . . . . . . . . . . . . 21.0 19.4 23.0 22.1 18.2 16.8 19.3 17.5 45.5 44.7 47.0 43.7
Location of residence 8
Within MSA . . . . . . . . . . . . . . . . . . . . 27.7 25.9 29.2 29.9 22.3 20.3 23.6 23.9 56.6 56.7 59.2 56.9
Outside MSA . . . . . . . . . . . . . . . . . . . 35.6 33.6 39.3 39.3 28.6 26.8 33.8 32.7 65.8 62.6 59.9 60.1
See footnotes at end of table.
Characteristic 1997 2000 2010 1 2015 1 1997 2000 2010 1 2015 1 1997 2000 2010 1 2015 1
1
Starting with 2007 data (shown in spreadsheet version), the hearing question, a component of the basic actions difficulty measure, was revised. Consequently, data for
basic actions difficulty prior to 2007 are not comparable with 2007 data and beyond. For more information on the impact of the revised hearing question, see Appendix
II, Hearing trouble.
2
A basic actions difficulty is defined as having difficulties in one or more of the following areas of functioning: movement, emotional, sensory (seeing or hearing), or
cognitive. For more information, see Appendix II, Basic actions difficulty. Starting with 2007 data, the hearing question, a component of basic actions difficulty, was
revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing question, see
Appendix II, Hearing trouble.
3
A complex activity limitation is defined as having one or more of the following limitations: maintaining independence (performing activities of daily living or instrumental
activities of daily living), socializing, or working. For more information, see Appendix II, Complex activity limitation.
4
Includes all other races not shown separately.
5
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
See Appendix II, Age adjustment.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Respondents were asked, "Do you have any trouble seeing, even when wearing glasses or contact lenses?" Respondents were also asked, "Are you blind or unable to
see at all?" In this analysis, any trouble seeing and blind are combined into one category.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
3
Includes all other races not shown separately and unknown education level.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 2544 years, 4554 years, 5564 years,
6574 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS). See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Starting in 2007, respondents were asked questions about their hearing WITHOUT the use of hearing aids or other listening devices. "Is your hearing excellent, good,
a little trouble hearing, moderate trouble, a lot of trouble, or are you deaf?" Hearing limitation questions differed slightly on the National Health Interview Survey across
the years for which data are shown. See Appendix II, Hearing trouble.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
3
Includes all other races not shown separately and unknown education level.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 2544 years, 4554 years, 5564 years,
6574 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Starting with Health, United States, 2013, the hearing measures shown in this table were revised to provide a consistent definition over time. For a longer trend,
see Health, United States, 2012. Available from: http://www.cdc.gov/nchs/hus.htm. Standard errors are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 6.1 7.5 6.6 7.5 7.4
100%199% . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 3.8 4.1 3.9 4.3 5.1
200%399% . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 2.1 3.5 2.6 3.1 3.0
400% or more . . . . . . . . . . . . . . . . . . . . . . . . . * 2.3 * *1.9 *1.4 2.7
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 7.8 9.2 10.2 9.6 9.8
100%199% . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.9 5.9 5.6 5.6 6.0
200%399% . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 2.3 2.9 2.6 3.2 2.9
400% or more . . . . . . . . . . . . . . . . . . . . . . . . 1.3 1.1 1.3 1.1 1.1 1.2
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . 8.7 6.0 7.2 7.6 7.7 6.9
100%199% . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 3.6 4.9 4.8 4.4 3.2
200%399% . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 *1.7 2.3 2.1 1.9 2.6
400% or more . . . . . . . . . . . . . . . . . . . . . . . . * *1.0 * * *1.5 *1.0
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Starting in 2013 (shown in spreadsheet version), the six psychological distress questions were moved to the adult selected items section of the sample adult
questionnaire. Observed differences between the 2012 and earlier estimates and the 2013 and later estimates may be partially or fully attributable to this change in
2
Serious psychological distress is measured by a six-question scale that asks respondents how often they experienced each of the six symptoms of psychological
distress in the past 30 days. Respondents must have answered all six questions to have a computed K6 score. Only those with K6 scores were included in this
analysis. See Appendix II, Serious psychological distress.
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
See Appendix II, Age adjustment.
4
Includes all other races not shown separately.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997
Standards and are not strictly comparable with estimates for earlier years. The five single-race categories plus multiple-race categories shown in the table conform to
the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
6
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
7
MSA is metropolitan statistical area. Starting with 20062007 data (shown in spreadsheet), MSA status is determined using 2000 census data and the 2000 standards
for defining MSAs. For data prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Sex, race, and age 1965 1 1979 1 1985 1 1990 1 2000 2005 2010 2012 2013 2014 2015
18 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
All persons. . . . . . . . . . . . . . . . . 41.9 33.3 29.9 25.3 23.1 20.8 19.3 18.2 17.9 17.0 15.3
Male . . . . . . . . . . . . . . . . . . . . 51.2 37.0 32.2 28.0 25.2 23.4 21.2 20.6 20.5 19.0 16.8
Female. . . . . . . . . . . . . . . . . . . 33.7 30.1 27.9 22.9 21.1 18.3 17.5 15.9 15.5 15.1 13.8
White male 4 . . . . . . . . . . . . . . . . 50.4 36.4 31.3 27.6 25.4 23.3 21.4 20.7 20.5 18.8 16.8
Black or African American male 4 . . . . . 58.8 43.9 40.2 32.8 25.7 25.9 23.3 22.0 21.8 21.7 20.3
White female 4 . . . . . . . . . . . . . . . 33.9 30.3 27.9 23.5 22.0 19.1 18.3 16.9 16.3 16.0 14.8
Black or African American female 4 . . . . 31.8 30.5 30.9 20.8 20.7 17.1 16.6 14.2 14.9 13.4 13.2
18 years and over, crude
All persons. . . . . . . . . . . . . . . . . 42.4 33.5 30.1 25.5 23.2 20.9 19.3 18.1 17.8 16.8 15.1
Male . . . . . . . . . . . . . . . . . . . . 51.9 37.5 32.6 28.4 25.6 23.9 21.5 20.5 20.5 18.8 16.7
Female. . . . . . . . . . . . . . . . . . . 33.9 29.9 27.9 22.8 20.9 18.1 17.3 15.8 15.3 14.8 13.6
White male 4 . . . . . . . . . . . . . . . . 51.1 36.8 31.7 28.0 25.7 23.6 21.4 20.3 20.3 18.5 16.5
Black or African American male 4 . . . . . 60.4 44.1 39.9 32.5 26.2 26.5 24.3 22.0 21.9 21.8 20.6
White female 4 . . . . . . . . . . . . . . . 34.0 30.1 27.7 23.4 21.4 18.7 17.9 16.6 15.9 15.5 14.3
Black or African American female 4 . . . . 33.7 31.1 31.0 21.2 20.8 17.3 17.0 14.7 15.1 13.5 13.1
All males
1844 years . . . . . . . . . . . . . . . . 57.9 40.4 35.2 31.4 29.2 27.1 23.9 24.0 22.9 21.7 18.5
1824 years . . . . . . . . . . . . . . . 54.1 35.0 28.0 26.6 28.1 28.0 22.8 20.1 21.9 18.5 15.0
2534 years . . . . . . . . . . . . . . . 60.7 43.9 38.2 31.6 28.9 27.7 26.1 28.0 24.4 23.7 21.3
3544 years . . . . . . . . . . . . . . . 58.2 41.8 37.6 34.5 30.2 26.0 22.5 22.8 22.1 22.0 18.3
4564 years . . . . . . . . . . . . . . . . 51.9 39.3 33.4 29.3 26.4 25.2 23.2 20.2 21.9 19.4 17.9
4554 years . . . . . . . . . . . . . . . 55.9 42.0 34.9 32.1 28.8 28.1 25.2 21.4 21.4 19.9 18.3
5564 years . . . . . . . . . . . . . . . 46.6 36.4 31.9 25.9 22.6 21.1 20.7 18.8 22.6 18.8 17.5
65 years and over . . . . . . . . . . . . . 28.5 20.9 19.6 14.6 10.2 8.9 9.7 10.6 10.6 9.8 9.7
White male 4
1844 years . . . . . . . . . . . . . . . . 57.1 40.0 34.6 31.3 30.2 27.7 24.6 24.8 23.4 21.7 18.9
1824 years . . . . . . . . . . . . . . . 53.0 34.3 28.4 27.4 30.4 29.7 23.8 21.9 23.5 20.0 15.6
2534 years . . . . . . . . . . . . . . . 60.1 43.6 37.3 31.6 29.7 27.7 26.6 28.4 24.6 23.4 20.9
3544 years . . . . . . . . . . . . . . . 57.3 41.3 36.6 33.5 30.6 26.3 23.1 23.3 21.9 21.2 19.1
4564 years . . . . . . . . . . . . . . . . 51.3 38.3 32.1 28.7 25.8 24.5 22.5 19.4 21.7 19.0 17.3
4554 years . . . . . . . . . . . . . . . 55.3 40.9 33.7 31.3 28.0 27.4 24.5 20.7 21.2 19.7 17.8
5564 years . . . . . . . . . . . . . . . 46.1 35.3 30.5 25.6 22.5 20.4 20.1 17.9 22.2 18.2 16.9
65 years and over . . . . . . . . . . . . . 27.7 20.5 18.9 13.7 9.8 7.9 9.6 10.3 10.0 9.4 9.3
Black or African American male 4
1844 years . . . . . . . . . . . . . . . . 66.3 45.2 39.6 32.9 25.5 25.1 22.6 21.3 20.9 22.2 20.2
1824 years . . . . . . . . . . . . . . . 62.8 40.2 27.2 21.3 20.9 21.6 18.8 13.2 *13.2 *13.9 *15.9
2534 years . . . . . . . . . . . . . . . 68.4 47.5 45.6 33.8 23.2 29.8 25.7 24.9 24.8 28.0 26.0
3544 years . . . . . . . . . . . . . . . 67.3 48.6 45.0 42.0 30.7 23.3 22.6 24.7 24.0 24.0 17.9
4564 years . . . . . . . . . . . . . . . . 57.9 50.0 46.1 36.7 32.2 32.4 31.8 24.6 25.7 24.0 22.8
4554 years . . . . . . . . . . . . . . . 62.4 51.5 47.7 42.0 35.6 33.9 33.2 23.3 25.7 22.5 20.5
5564 years . . . . . . . . . . . . . . . 51.8 47.9 44.4 30.2 26.3 29.8 29.6 26.4 25.6 25.9 25.5
65 years and over . . . . . . . . . . . . . 36.4 26.2 27.7 21.5 14.2 16.8 10.0 17.4 15.5 13.9 16.0
All females
1844 years . . . . . . . . . . . . . . . . 42.1 34.7 31.4 25.6 24.5 21.2 19.1 16.9 16.6 16.6 14.5
1824 years . . . . . . . . . . . . . . . 38.1 33.8 30.4 22.5 24.9 20.7 17.4 14.5 15.4 14.8 11.0
2534 year . . . . . . . . . . . . . . . 43.7 33.7 32.0 28.2 22.3 21.5 20.6 19.4 17.9 17.5 15.0
3544 years . . . . . . . . . . . . . . . 43.7 37.0 31.5 24.8 26.2 21.3 19.0 16.1 16.3 17.0 16.5
4564 years . . . . . . . . . . . . . . . . 32.0 30.7 29.9 24.8 21.7 18.8 19.1 18.9 18.1 16.8 16.1
4554 years . . . . . . . . . . . . . . . 37.5 32.6 32.4 28.5 22.2 20.9 21.3 21.3 20.6 18.7 18.4
5564 years . . . . . . . . . . . . . . . 25.0 28.6 27.4 20.5 20.9 16.1 16.5 16.2 15.2 14.8 13.7
65 years and over . . . . . . . . . . . . . 9.6 13.2 13.5 11.5 9.3 8.3 9.3 7.5 7.5 7.5 7.3
See footnotes at end of table.
Sex, race, and age 1965 1 1979 1 1985 1 1990 1 2000 2005 2010 2012 2013 2014 2015
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1824 years, 2534 years, 3544 years, 4564 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
3
Starting with 1993 data (shown in spreadsheet version), current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now every
day or some days. For previous definition, see Appendix II, Cigarette smoking.
4
The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Starting with 1999 data, race-specific estimates are tabulated according to
the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The
single-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial
group. Prior to 1999, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified
multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of
Hispanic origin. See Appendix II, Hispanic origin; Race.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the core questionnaire (1965) and the following questionnaire supplements: hypertension (1974),
smoking (1979), alcohol and health practices (1983), health promotion and disease prevention (1985, 19901991), cancer control and cancer epidemiology (1992), and
year 2000 objectives (19931995). Starting with 1997, data are from the family core and sample adult questionnaires. See Appendix I, National Health Interview Survey
(NHIS).
Sex, race, and education level 1974 1 1979 1 1985 1 1990 1 1995 1 2000 2005 2010 2014 2015
25 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
All persons 4 . . . . . . . . . . . . . . . . . . 36.9 33.1 30.0 25.4 24.5 22.6 20.3 19.2 17.1 15.6
No high school diploma or GED. . . . . . . . 43.7 40.7 40.8 36.7 35.6 31.6 28.2 26.9 24.4 25.6
High school diploma or GED . . . . . . . . . 36.2 33.6 32.0 29.1 29.1 29.2 27.0 27.0 25.9 22.9
Some college, no bachelor's degree . . . . . 35.9 33.2 29.5 23.4 22.6 21.7 21.8 21.3 18.6 17.9
Bachelor's degree or higher . . . . . . . . . . 27.2 22.6 18.5 13.9 13.6 10.9 9.1 8.3 7.0 5.9
All males 4 . . . . . . . . . . . . . . . . . . . 42.9 37.3 32.8 28.2 26.4 24.7 22.7 21.0 19.1 17.1
No high school diploma or GED. . . . . . . . 52.3 47.6 45.7 42.0 39.7 36.0 31.7 29.7 27.7 28.6
High school diploma or GED . . . . . . . . . 42.4 38.9 35.5 33.1 32.7 32.1 29.9 29.3 28.2 24.3
Some college, no bachelor's degree . . . . . 41.8 36.5 32.9 25.9 23.7 23.3 24.9 23.2 20.2 18.7
Bachelor's degree or higher . . . . . . . . . . 28.3 22.7 19.6 14.5 13.8 11.6 9.7 8.7 7.9 6.6
White males 4,5 . . . . . . . . . . . . . . . . . 41.9 36.7 31.7 27.6 25.9 24.7 22.4 21.0 18.6 16.9
No high school diploma or GED. . . . . . . . 51.5 47.6 45.0 41.8 38.7 38.2 31.6 29.4 26.0 27.1
High school diploma or GED . . . . . . . . . 42.0 38.5 34.8 32.9 32.9 32.4 30.0 29.6 27.9 25.3
Some college, no bachelor's degree . . . . . 41.6 36.4 32.2 25.4 23.3 23.5 24.5 23.4 20.3 18.0
Bachelor's degree or higher . . . . . . . . . . 27.8 22.5 19.1 14.4 13.4 11.3 9.3 8.8 7.4 6.6
Black or African American males 4,5 . . . . . . 53.4 44.4 42.1 34.5 31.6 26.4 26.5 23.9 22.9 20.9
No high school diploma or GED. . . . . . . . 58.1 49.7 50.5 41.6 41.9 38.2 35.9 34.4 38.7 38.1
High school diploma or GED . . . . . . . . . *50.7 48.6 41.8 37.4 36.6 29.0 30.1 28.8 28.7 22.1
Some college, no bachelor's degree . . . . . *45.3 39.2 41.8 28.1 26.4 19.9 27.4 24.2 18.8 23.0
Bachelor's degree or higher . . . . . . . . . . *41.4 *36.8 *32.0 *20.8 *17.3 14.6 10.0 8.1 9.8 *6.9
All females 4 . . . . . . . . . . . . . . . . . . 32.0 29.5 27.5 22.9 22.9 20.5 18.0 17.5 15.2 14.3
No high school diploma or GED. . . . . . . . 36.6 34.8 36.5 31.8 31.7 27.1 24.6 23.7 21.2 22.6
High school diploma or GED . . . . . . . . . 32.2 29.8 29.5 26.1 26.4 26.6 24.1 24.9 23.5 21.2
Some college, no bachelor's degree . . . . . 30.1 30.0 26.3 21.0 21.6 20.4 19.1 19.6 17.3 17.2
Bachelor's degree or higher . . . . . . . . . . 25.9 22.5 17.1 13.3 13.3 10.1 8.5 7.9 6.2 5.3
White females 4,5 . . . . . . . . . . . . . . . . 31.7 29.7 27.3 23.3 23.1 21.0 18.6 18.3 16.0 15.3
No high school diploma or GED. . . . . . . . 36.8 35.8 36.7 33.4 32.4 28.4 24.6 24.0 21.0 23.8
High school diploma or GED . . . . . . . . . 31.9 29.9 29.4 26.5 26.8 27.8 25.9 25.8 25.4 22.7
Some college, no bachelor's degree . . . . . 30.4 30.7 26.7 21.2 22.2 21.1 19.5 21.0 18.3 18.6
Bachelor's degree or higher . . . . . . . . . . 25.5 21.9 16.5 13.4 13.5 10.2 9.1 8.7 6.6 5.9
Black or African American females 4,5 . . . . . 35.6 30.3 32.0 22.4 25.7 21.6 17.5 17.0 14.0 13.9
No high school diploma or GED. . . . . . . . 36.1 31.6 39.4 26.3 32.3 31.1 27.8 25.8 22.5 24.0
High school diploma or GED . . . . . . . . . 40.9 32.6 32.1 24.1 27.8 25.4 18.2 22.9 15.9 18.0
Some college, no bachelor's degree . . . . . 32.3 *28.9 23.9 22.7 20.8 20.4 17.5 15.0 14.4 14.5
Bachelor's degree or higher . . . . . . . . . . *36.3 *43.3 26.6 17.0 17.3 10.8 *6.6 *6.6 6.9 *4.5
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 2534 years, 3544 years, 4564 years, and 65 years and over. See Appendix
II, Age adjustment. For age groups where smoking was 0% or 100%, the age-adjustment procedure was modified to substitute the percentage smoking from the next
lower education group.
3
Starting with 1993 data (shown in spreadsheet version), current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now every
day or some days. For previous definition, see Appendix II, Cigarette smoking.
4
Includes unknown education level. Education categories shown are for 1997 and subsequent years. GED is General Educational Development high school equivalency
diploma. In 19741995 the following categories based on number of years of school completed were used: less than 12 years, 12 years, 1315 years, 16 years or
more. See Appendix II, Education.
5
The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Starting with 1999 data, race-specific estimates are tabulated according to
the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The
single-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial
group. Prior to 1999, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified
multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of
Hispanic origin. See Appendix II, Hispanic origin; Race.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: hypertension (1974), smoking (1979), alcohol and health
practices (1983), health promotion and disease prevention (1985, 19901991), cancer control and cancer epidemiology (1992), and year 2000 objectives (19931995).
Starting with 1997, data are from the family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Male Female
Characteristic 19901992 1
19992001 20132015 19901992 1
19992001 20132015
18 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
All persons 4 . . . . . . . . . . . . . . . . . . . . . 27.9 25.0 18.8 23.7 21.1 14.8
Race 5
Male Female
Characteristic 19901992 1
19992001 20132015 19901992 1
19992001 20132015
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: health promotion and disease prevention (19901991),
cancer control and cancer epidemiology (1992), and year 2000 objectives (19931995). Starting with 1997, data are from the family core and sample adult
questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Misuse of prescription
Any illicit drug 1 Marijuana psychotherapeutic drugs 2
Age, sex, race, and
Hispanic origin 2002 2014 2015 2002 2014 2015 2002 2014 2015
Percent of population
12 years and over . . . . . . . . . . . . . . . -- -- 10.1 6.2 8.4 8.3 -- -- 2.4
Age
1213 years . . . . . . . . . . . . . . . . . . -- -- 2.6 1.4 1.1 0.8 -- -- 0.9
1415 years . . . . . . . . . . . . . . . . . . -- -- 7.2 7.6 5.5 5.7 -- -- 1.7
1617 years . . . . . . . . . . . . . . . . . . -- -- 16.3 15.7 15.0 14.2 -- -- 3.3
1825 years . . . . . . . . . . . . . . . . . . -- -- 22.3 17.3 19.6 19.8 -- -- 5.1
2634 years . . . . . . . . . . . . . . . . . . -- -- 15.4 7.7 12.7 12.9 -- -- 3.7
35 years and over . . . . . . . . . . . . . . . -- -- 6.6 3.1 5.2 5.1 -- -- 1.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . -- -- 12.5 8.1 10.9 10.6 -- -- 2.6
Female. . . . . . . . . . . . . . . . . . . . . -- -- 7.9 4.4 6.0 6.2 -- -- 2.2
Age and sex
1217 years . . . . . . . . . . . . . . . . . . -- -- 8.8 8.2 7.4 7.0 -- -- 2.0
Male. . . . . . . . . . . . . . . . . . . . . -- -- 8.8 9.1 7.9 7.5 -- -- 1.7
Female . . . . . . . . . . . . . . . . . . . -- -- 8.8 7.2 6.8 6.5 -- -- 2.3
Hispanic origin and race 3
Not Hispanic or Latino:
White only. . . . . . . . . . . . . . . . . . -- -- 10.2 6.5 8.7 8.4 -- -- 2.6
Black or African American only . . . . . . . -- -- 12.5 7.4 10.3 10.7 -- -- 1.8
American Indian or Alaska Native only . . . -- -- 14.2 6.7 11.8 11.2 -- -- 2.6
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . -- -- 9.8 4.4 12.1 9.2 -- -- 1.7
Asian only . . . . . . . . . . . . . . . . . . -- -- 4.0 1.8 2.8 3.0 -- -- 0.7
2 or more races . . . . . . . . . . . . . . . -- -- 17.2 9.0 12.4 13.4 -- -- 4.8
Hispanic or Latino . . . . . . . . . . . . . . . -- -- 9.2 4.3 6.7 7.2 -- -- 2.3
Percent of population
12 years and over . . . . . . . . . . . . . . . 51.0 52.7 51.7 -- -- 24.9 -- -- 6.5
Age
1213 years . . . . . . . . . . . . . . . . . . 4.3 2.1 1.3 -- -- 0.7 -- -- 0.0
1415 years . . . . . . . . . . . . . . . . . . 16.6 8.5 7.4 -- -- 3.8 -- -- 0.3
1617 years . . . . . . . . . . . . . . . . . . 32.6 23.3 19.7 -- -- 12.6 -- -- 2.3
1825 years . . . . . . . . . . . . . . . . . . 60.5 59.6 58.3 -- -- 39.0 -- -- 10.9
2634 years . . . . . . . . . . . . . . . . . . 61.4 66.0 65.0 -- -- 38.3 -- -- 9.7
35 years and over . . . . . . . . . . . . . . . 52.1 54.4 53.5 -- -- 21.8 -- -- 5.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . 57.4 57.3 56.2 31.2 30.0 29.6 10.8 9.3 8.9
Female. . . . . . . . . . . . . . . . . . . . . 44.9 48.4 47.4 -- -- 20.5 -- -- 4.2
Age and sex
1217 years . . . . . . . . . . . . . . . . . . 17.6 11.5 9.6 -- -- 5.8 -- -- 0.9
Male. . . . . . . . . . . . . . . . . . . . . 17.4 10.8 9.3 11.4 6.4 5.8 3.1 1.2 1.1
Female . . . . . . . . . . . . . . . . . . . 17.9 12.3 9.9 -- -- 5.8 -- -- 0.7
Hispanic origin and race 3
Not Hispanic or Latino:
White only. . . . . . . . . . . . . . . . . . 55.0 57.7 57.0 -- -- 26.0 -- -- 7.6
Black or African American only . . . . . . . 39.9 44.2 43.8 -- -- 23.4 -- -- 4.8
American Indian or Alaska Native only . . . 44.7 42.3 37.9 -- -- 24.1 -- -- 4.7
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . * 37.9 33.8 -- -- 17.8 -- -- 3.0
Asian only . . . . . . . . . . . . . . . . . . 37.1 38.7 39.7 -- -- 14.0 -- -- 2.2
2 or more races . . . . . . . . . . . . . . . 49.9 49.5 42.8 -- -- 22.9 -- -- 6.8
Hispanic or Latino . . . . . . . . . . . . . . . 42.8 44.4 42.4 -- -- 25.7 -- -- 4.8
See footnotes at end of table.
Percent of population
12 years and over . . . . . . . . . . . . . . . 30.4 25.2 23.9 26.0 20.8 19.4 5.4 4.5 4.7
Age
1213 years . . . . . . . . . . . . . . . . . . 3.8 1.1 0.6 3.2 0.7 0.5 0.7 0.3 0.2
1415 years . . . . . . . . . . . . . . . . . . 13.4 5.1 4.6 11.2 3.4 3.1 3.8 1.5 1.2
1617 years . . . . . . . . . . . . . . . . . . 29.0 14.4 12.4 24.9 10.2 8.7 9.3 4.4 4.8
1825 years . . . . . . . . . . . . . . . . . . 45.3 35.0 33.0 40.8 28.4 26.7 11.0 9.7 8.9
2634 years . . . . . . . . . . . . . . . . . . 38.2 34.8 35.1 32.7 29.4 29.3 6.6 6.8 7.8
35 years and over . . . . . . . . . . . . . . . 27.9 23.7 22.1 23.4 19.7 17.9 4.1 3.3 3.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . 37.0 31.1 29.6 28.7 23.2 21.8 9.4 7.5 7.6
Female. . . . . . . . . . . . . . . . . . . . . 24.3 19.7 18.5 23.4 18.6 17.1 1.7 1.7 2.0
Age and sex
1217 years . . . . . . . . . . . . . . . . . . 15.2 7.0 6.0 13.0 4.9 4.2 4.5 2.1 2.1
Male. . . . . . . . . . . . . . . . . . . . . 16.0 8.2 7.0 12.3 5.1 4.6 6.2 2.7 2.6
Female . . . . . . . . . . . . . . . . . . . 14.4 5.8 4.9 13.6 4.6 3.8 2.7 1.5 1.5
Hispanic origin and race 3
Not Hispanic or Latino:
White only. . . . . . . . . . . . . . . . . . 32.0 27.6 25.9 26.9 22.3 20.7 5.5 4.6 4.5
Black or African American only . . . . . . . 28.8 26.6 26.0 25.3 22.5 21.3 6.8 6.5 8.0
American Indian or Alaska Native only . . . 44.3 37.8 37.0 37.1 32.5 29.5 5.2 4.2 6.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . * 30.6 19.2 * 25.4 16.3 4.1 3.2 4.2
Asian only . . . . . . . . . . . . . . . . . . 18.6 10.2 11.4 17.7 9.2 10.0 1.1 1.2 2.2
2 or more races . . . . . . . . . . . . . . . 38.1 29.5 31.9 35.0 24.4 26.8 5.5 6.5 5.9
Hispanic or Latino . . . . . . . . . . . . . . . 25.2 18.8 17.7 23.0 16.7 15.3 5.0 3.7 3.7
* Estimates are considered unreliable. Data not shown if the relative standard error is greater than 17.5% of the log transformation of the proportion, the minimum
effective sample size is less than 68, the minimum nominal sample size is less than 100, or the prevalence is close to 0% or 100%.
- - - Data not available.
1
Any illicit drug includes marijuana, cocaine (including crack), heroin, hallucinogens (including LSD, PCP, peyote, mescaline, psilocybin mushrooms, "Ecstasy,"
ketamine, DMT/AMT/"Foxy," and Salvia divinorum), inhalants, methamphetamine, or the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives.
See Appendix II, Illicit drug use.
2
Misuse of prescription psychotherapeutic drugs is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater
amounts, more often, or longer than told to take a drug; or use in any other way not directed by a doctor.
3
Persons of Hispanic origin may be of any race. Data on race and Hispanic origin were collected using the 1997 Revisions to the Standards for the Classification of
Federal Data on Race and Ethnicity. Single-race categories shown include persons who reported only one racial group. The category 2 or more races includes persons
who reported more than one racial group. See Appendix II, Hispanic origin; Race.
4
Binge alcohol use for men is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. Starting in 2015, binge alcohol use
for women is defined as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. Occasion is defined as at the same time or within a
couple of hours of each other. See Appendix II, Alcohol consumption; Binge drinking.
5
Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days. By definition, all heavy alcohol users
are also binge alcohol users.
6
Any tobacco product includes cigarettes, smokeless tobacco (such as snuff, dip, chewing tobacco, or "snus"), cigars, or pipe tobacco. See Appendix II,
Cigarette smoking.
NOTES: The National Survey on Drug Use & Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA), began a new baseline in 2002
and cannot be compared with previous years. The NSDUH questionnaire underwent a partial redesign in 2015, including changes to some questions. Consequently,
for some categories, data for prior years are not comparable to 2015 estimates and are not shown in this table. Starting with 2011 data, 2010-census based control
totals were used in the weighting process. Because of methodological differences among the National Survey on Drug Use & Health, the Monitoring the Future (MTF)
Study, and the Youth Risk Behavior Survey (YRBS), rates of substance use measured by these surveys are not directly comparable. See Appendix I, Monitoring the
Future (MTF) Study; National Survey on Drug Use & Health (NSDUH); Youth Risk Behavior Survey (YRBS). See Appendix II, Substance use. Data for additional years
are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous
editions of Health, United States.
SOURCE: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use & Health.
Available from: http://www.samhsa.gov/data/population-data-nsduh. See Appendix I, National Survey on Drug Use & Health (NSDUH).
sex, and race 1980 1990 2000 2005 2010 2011 2012 2013 2014 2015
sex, and race 1980 1990 2000 2005 2010 2011 2012 2013 2014 2015
sex, and race 1980 1990 2000 2005 2010 2011 2012 2013 2014 2015
NOTES: Estimates for Hispanic students are not shown due to small sample size. For 2-year estimates for Hispanic students, see Johnston LD, O'Malley PM, Miech
RA, Bachman JG, Schulenberg JE. (2015). Demographic subgroup trends among adolescents in the use of various licit and illicit drugs 19752014 (Monitoring the
Future Occasional Paper No. 83). Ann Arbor, MI: Institute for Social Research, University of Michigan, 530 pp. Available at: http://monitoringthefuture.org/pubs.
html#papers. Because of methodological differences among the National Survey on Drug Use & Health (NSDUH), the Monitoring the Future (MTF) Study, and the
Youth Risk Behavior Survey (YRBS), rates of substance use measured by these surveys are not directly comparable. See Appendix I, National Survey on Drug Use &
Health (NSDUH); Monitoring the Future (MTF) Study; Youth Risk Behavior Survey (YRBS). See Appendix II, Cigarette smoking; Illicit drug use; Substance use. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Monitoring the Future Study. Institute for Social Research, the University of Michigan. Supported by National Institutes of Health, National Institute on Drug
Abuse. See Appendix I, Monitoring the Future (MTF) Study.
Percent of students
Total . . . . . . . . . . . . . . . . . . . . 29.0 19.0 17.0 17.7 42.5 33.2 24.7 22.6 26.1 17.4 17.9 16.2
Male
Total . . . . . . . . . . . . . . . . . . . . 20.8 14.2 11.6 12.2 50.2 43.1 30.2 28.4 40.6 29.3 28.1 24.3
9th grade . . . . . . . . . . . . . . . . . . 17.6 14.7 9.9 10.7 57.8 50.0 33.2 32.5 44.4 33.7 26.4 24.6
10th grade . . . . . . . . . . . . . . . . . 19.5 13.8 11.3 10.8 50.2 45.0 30.9 29.4 41.5 28.4 26.4 25.5
11th grade . . . . . . . . . . . . . . . . . 25.3 14.1 14.0 13.3 51.0 38.0 31.6 27.1 44.0 28.1 30.5 23.0
12th grade . . . . . . . . . . . . . . . . . 20.7 13.7 11.0 14.0 42.3 36.5 23.8 22.9 33.1 25.6 29.5 23.4
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . 21.7 14.9 11.4 11.5 49.1 43.1 27.1 26.6 41.2 31.3 33.4 28.0
Black or African American . . . . . . 13.3 9.2 10.2 11.0 58.4 43.9 37.5 38.6 43.4 22.4 18.2 17.6
Hispanic or Latino . . . . . . . . . . . . 18.0 12.2 11.5 12.4 48.5 42.4 34.2 27.3 40.0 26.0 23.8 20.2
Female
Total . . . . . . . . . . . . . . . . . . . . 37.2 23.6 22.4 23.4 34.4 23.9 19.2 16.5 10.9 6.2 7.9 7.5
9th grade . . . . . . . . . . . . . . . . . . 40.3 26.2 24.6 26.5 42.9 30.3 23.3 22.6 10.4 7.4 8.6 6.6
10th grade . . . . . . . . . . . . . . . . . 39.7 24.1 23.4 25.7 35.4 24.9 21.9 17.6 11.1 5.4 9.2 7.2
11th grade . . . . . . . . . . . . . . . . . 38.4 23.6 22.3 22.1 34.5 20.3 16.7 12.8 12.9 5.9 5.9 8.0
12th grade . . . . . . . . . . . . . . . . . 30.7 18.9 18.7 18.6 25.4 16.9 13.9 12.0 9.5 5.3 7.5 8.0
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . 38.6 24.2 21.1 22.8 32.2 21.7 14.6 13.5 7.5 5.1 8.3 8.1
Black or African American . . . . . . 29.4 17.2 18.6 18.7 43.8 29.6 32.1 25.4 23.6 8.6 7.2 6.2
Hispanic or Latina . . . . . . . . . . . . 34.6 26.5 26.0 25.6 34.8 29.3 22.8 18.6 12.9 7.4 7.7 7.1
Percent of students
Total . . . . . . . . . . . . . . . . . . . . 25.9 14.1 7.6 6.1 39.9 30.7 21.9 20.0 -- -- 41.4 41.5
Male
Total . . . . . . . . . . . . . . . . . . . . 30.0 18.1 9.1 7.2 40.0 31.8 21.4 19.6 -- -- 41.8 42.4
9th grade . . . . . . . . . . . . . . . . . . 30.0 19.4 9.8 7.0 33.9 29.2 18.1 19.1 -- -- 18.3 17.4
10th grade . . . . . . . . . . . . . . . . . 25.5 16.6 8.4 7.6 36.6 31.5 19.9 19.0 -- -- 27.8 25.2
11th grade . . . . . . . . . . . . . . . . . 29.5 17.5 9.7 7.1 45.0 32.8 23.4 20.4 -- -- 49.6 50.1
12th grade . . . . . . . . . . . . . . . . . 34.7 18.6 8.3 6.1 44.7 34.5 25.3 19.9 -- -- 61.0 61.9
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . 28.6 17.7 8.5 5.3 40.2 31.2 19.6 17.7 -- -- 45.1 45.0
Black or African American . . . . . . 37.5 20.3 11.8 12.4 37.5 31.2 18.9 20.6 -- -- 31.5 33.0
Hispanic or Latino . . . . . . . . . . . . 37.1 17.7 8.9 6.8 47.2 37.1 28.9 25.3 -- -- 39.5 42.2
Female
Total . . . . . . . . . . . . . . . . . . . . 21.6 10.2 6.1 4.9 39.8 29.6 22.4 20.2 -- -- 40.9 40.4
9th grade . . . . . . . . . . . . . . . . . . 25.0 10.8 7.1 5.5 36.0 31.3 20.8 21.3 -- -- 15.1 14.4
10th grade . . . . . . . . . . . . . . . . . 20.4 10.3 5.7 4.5 38.8 29.9 23.8 18.4 -- -- 25.0 24.7
11th grade . . . . . . . . . . . . . . . . . 20.8 9.7 6.3 4.1 39.7 25.4 21.8 20.1 -- -- 48.7 45.1
12th grade . . . . . . . . . . . . . . . . . 20.2 9.4 5.1 5.1 44.8 31.3 23.2 21.0 -- -- 59.5 60.8
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . 18.7 9.7 4.7 3.5 40.9 29.4 19.9 17.5 -- -- 46.7 45.3
Black or African American . . . . . . 31.9 12.2 7.1 7.6 33.8 24.2 24.8 21.2 -- -- 26.5 33.1
Hispanic or Latina . . . . . . . . . . . . 25.9 11.3 8.7 6.3 46.7 39.3 29.2 27.3 -- -- 32.1 28.2
See footnotes at end of table.
Ever had sexual intercourse Did not use a condom at last sex 6,7 Ever physically forced to have sex
Sex, grade level, race,
and Hispanic origin 1991 2001 2013 2015 1991 2001 2013 2015 1991 2001 2013 2015
Percent of students
Total . . . . . . . . . . . . . . . . . . . . 54.1 45.6 46.8 41.2 53.8 42.1 40.9 43.1 -- 7.7 7.3 6.7
Male
Total . . . . . . . . . . . . . . . . . . . . 57.4 48.5 47.5 43.2 45.5 34.9 34.2 38.5 -- 5.1 4.2 3.1
9th grade . . . . . . . . . . . . . . . . . . 45.6 40.5 32.0 27.3 44.1 31.1 30.5 36.7 -- 5.9 3.8 2.1
10th grade . . . . . . . . . . . . . . . . . 50.9 42.2 41.1 37.9 43.1 30.7 30.7 34.4 -- 4.1 2.8 3.9
11th grade . . . . . . . . . . . . . . . . . 64.5 54.0 54.3 51.2 43.2 34.7 29.4 37.5 -- 4.3 4.7 2.8
12th grade . . . . . . . . . . . . . . . . . 68.3 61.0 65.4 59.0 49.3 40.8 42.0 42.6 -- 5.8 5.5 3.5
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . 52.7 45.1 42.2 39.5 44.8 36.2 38.2 41.9 -- 3.8 3.1 2.0
Black or African American . . . . . . 88.1 68.8 68.4 58.8 43.0 27.3 27.0 26.4 -- 8.5 5.2 4.4
Hispanic or Latino . . . . . . . . . . . . 64.1 53.0 51.7 45.1 53.0 40.9 33.5 37.5 -- 6.2 5.2 4.0
Female
Total . . . . . . . . . . . . . . . . . . . . 50.8 42.9 46.0 39.2 62.0 48.7 46.9 48.0 -- 10.3 10.5 10.3
9th grade . . . . . . . . . . . . . . . . . . 32.2 29.1 28.1 20.7 49.7 33.4 43.5 43.3 -- 8.6 8.3 9.4
10th grade . . . . . . . . . . . . . . . . . 45.3 39.3 41.7 33.5 63.6 47.8 44.5 46.0 -- 10.7 11.8 7.9
11th grade . . . . . . . . . . . . . . . . . 60.2 49.7 53.9 48.2 59.3 47.3 45.2 47.1 -- 9.9 10.5 12.0
12th grade . . . . . . . . . . . . . . . . . 65.1 60.1 62.8 57.2 67.4 58.8 51.6 51.2 -- 12.2 11.2 11.9
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . 47.1 41.3 45.3 40.3 62.0 49.0 46.8 44.1 -- 9.8 9.1 9.9
Black or African American . . . . . . 75.9 53.4 53.4 37.4 60.6 39.3 44.7 53.3 -- 10.6 11.5 10.3
Hispanic or Latina . . . . . . . . . . . . 43.3 44.0 46.9 39.8 73.1 52.4 49.3 51.7 -- 11.6 12.2 10.1
Percent of students
Total . . . . . . . . . . . . . . . . . . . . -- 38.3 32.5 24.7 -- -- 41.3 41.7 -- -- 72.9 72.9
Male
Total . . . . . . . . . . . . . . . . . . . . -- 41.8 32.8 25.0 -- -- 42.3 40.6 -- -- 63.4 64.0
9th grade . . . . . . . . . . . . . . . . . . -- 51.4 34.6 26.3 -- -- 43.0 42.5 -- -- 59.5 59.9
10th grade . . . . . . . . . . . . . . . . . -- 42.3 32.4 24.6 -- -- 44.9 43.4 -- -- 65.4 63.3
11th grade . . . . . . . . . . . . . . . . . -- 36.8 32.3 24.6 -- -- 42.4 36.1 -- -- 63.0 65.7
12th grade . . . . . . . . . . . . . . . . . -- 33.5 31.9 24.4 -- -- 38.4 40.8 -- -- 66.5 67.4
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . -- 35.7 25.7 21.4 -- -- 39.1 38.9 -- -- 62.5 61.5
Black or African American . . . . . . -- 69.1 55.3 37.0 -- -- 51.9 41.2 -- -- 62.8 69.2
Hispanic or Latino . . . . . . . . . . . . -- 49.7 36.5 27.4 -- -- 42.0 45.1 -- -- 66.1 65.8
Female
Total . . . . . . . . . . . . . . . . . . . . -- 35.0 32.2 24.4 -- -- 40.4 42.8 -- -- 82.3 82.3
9th grade . . . . . . . . . . . . . . . . . . -- 39.6 35.3 25.3 -- -- 46.5 48.7 -- -- 79.9 79.1
10th grade . . . . . . . . . . . . . . . . . -- 36.2 32.2 24.1 -- -- 41.0 43.3 -- -- 79.5 81.0
11th grade . . . . . . . . . . . . . . . . . -- 32.5 30.4 22.4 -- -- 37.6 38.1 -- -- 85.6 84.0
12th grade . . . . . . . . . . . . . . . . . -- 29.2 30.6 25.9 -- -- 35.4 40.4 -- -- 84.7 85.7
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . -- 26.5 24.3 18.8 -- -- 35.6 38.3 -- -- 81.3 80.5
Black or African American . . . . . . -- 68.6 52.2 41.5 -- -- 46.6 48.4 -- -- 84.0 83.4
Hispanic or Latina . . . . . . . . . . . . -- 46.0 39.0 29.2 -- -- 44.8 47.4 -- -- 82.6 85.3
See footnotes at end of table.
Did not eat breakfast on all 7 days 7,10 Got fewer than 8 hours of sleep 7,11
Sex, grade level, race,
and Hispanic origin 1991 2001 2013 2015 1991 2001 2013 2015
Percent of students
Total . . . . . . . . . . . . . . . . . . . . -- -- 61.9 63.7 -- -- 68.3 72.7
Male
Total . . . . . . . . . . . . . . . . . . . . -- -- 57.6 59.5 -- -- 65.5 69.9
9th grade . . . . . . . . . . . . . . . . . . -- -- 51.1 53.4 -- -- 55.0 60.7
10th grade . . . . . . . . . . . . . . . . . -- -- 58.2 57.7 -- -- 62.9 66.2
11th grade . . . . . . . . . . . . . . . . . -- -- 60.4 62.9 -- -- 70.6 77.1
12th grade . . . . . . . . . . . . . . . . . -- -- 62.3 65.3 -- -- 75.7 77.4
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . -- -- 55.1 56.7 -- -- 64.6 68.9
Black or African American . . . . . . -- -- 64.3 69.2 -- -- 71.2 74.4
Hispanic or Latino . . . . . . . . . . . . -- -- 60.4 60.5 -- -- 64.6 67.1
Female
Total . . . . . . . . . . . . . . . . . . . . -- -- 66.2 67.9 -- -- 71.1 75.6
9th grade . . . . . . . . . . . . . . . . . . -- -- 67.5 68.1 -- -- 65.2 70.9
10th grade . . . . . . . . . . . . . . . . . -- -- 65.6 68.9 -- -- 70.1 76.9
11th grade . . . . . . . . . . . . . . . . . -- -- 65.2 67.6 -- -- 72.4 77.0
12th grade . . . . . . . . . . . . . . . . . -- -- 66.3 67.1 -- -- 77.6 77.8
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . -- -- 63.0 65.2 -- -- 70.6 75.1
Black or African American . . . . . . -- -- 75.1 75.3 -- -- 72.4 79.4
Hispanic or Latina . . . . . . . . . . . . -- -- 67.9 69.9 -- -- 69.8 73.2
1
During the past 12 months.
2
During the past 30 days.
3
Such as a gun, knife, or club.
4
When riding in a car driven by someone else.
5
Among students who drove a vehicle on at least 1 day during the past 30 days.
6
Among students who were currently sexually active.
7
Percent is 100 minus percent presented in MMWR Youth Risk Behavior Surveillance Summaries. See Surveillance Summaries at
https://www.cdc.gov/healthyyouth/data/yrbs/index.htm.
8
On an average school day.
9
For something that was not school work.
10
During the past 7 days.
11
On an average school night.
NOTES: Only youths attending school participated in the survey. YRBS is conducted biennially. Persons of Hispanic origin may be of any race. Not all questions were
asked for all years. All available and comparable data are presented as shown. See Appendix II, Hispanic origin; Race; Suicidal ideation. Standard errors for selected
years are available in the spreadsheet version of this table. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/National Center for HIV, Hepatitis, STD, and TB Prevention, Youth Risk Behavior Survey. See Youth Online website at http://nccd.cdc.gov/youthonline.
See Appendix I, Youth Risk Behavior Survey (YRBS).
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Hypertension 2,3
(measured high blood pressure and/or Uncontrolled high blood pressure
Sex, age, race taking antihypertensive medication) among persons with hypertension 4
and Hispanic origin 1,
and percent of poverty level 19881994 19992002 20072010 20112014 19881994 19992002 20072010 20112014
Hypertension 2,3
(measured high blood pressure and/or Uncontrolled high blood pressure
Sex, age, race taking antihypertensive medication) among persons with hypertension 4
and Hispanic origin 1,
and percent of poverty level 19881994 19992002 20072010 20112014 19881994 19992002 20072010 20112014
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%.
1
Persons of Hispanic and Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to
the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The non-Hispanic race
categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group.
Prior to data year 1999, estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Hypertension is defined as having measured high blood pressure and/or taking antihypertensive medication. High blood pressure is defined as having measured
systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90 mm Hg. Those with high blood pressure also may be taking prescribed medicine for high
blood pressure. Those taking antihypertensive medication may not have measured high blood pressure but are still classified as having hypertension. See Appendix II,
Blood pressure, high.
3
Respondents were asked, "Are you now taking prescribed medicine for your high blood pressure?"
4
Uncontrolled high blood pressure among persons with hypertension is defined as measured systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90
mm Hg, among those with measured high blood pressure or reporting taking antihypertensive medication. See Appendix II, Blood pressure, high.
5
Estimates are age-adjusted to the year 2000 standard population using five age groups: 2034 years, 3544 years, 4554 years, 5564 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
6
Includes persons of all races and Hispanic origins, not just those shown separately.
7
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (6% in 20112014). See Appendix II, Family income; Poverty.
NOTES: Percentages are based on the average of blood pressure measurements taken. In 20112014, 85% of participants had three systolic or diastolic blood
pressure readings. Excludes pregnant women. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
20 years and over, crude Mean serum total cholesterol level, mg/dL
Both sexes 4 . . . . . . . . . . . . . . . . . . . . 204 203 200 197 192
Male . . . . . . . . . . . . . . . . . . . . . . . . 202 202 198 194 188
Female . . . . . . . . . . . . . . . . . . . . . . . 206 204 202 199 196
Not Hispanic or Latino:
White only. . . . . . . . . . . . . . . . . . . . 206 205 202 198 194
White only, male . . . . . . . . . . . . . . 203 203 198 193 188
White only, female . . . . . . . . . . . . . 208 206 205 201 199
Black or African American only . . . . . . . 200 197 193 191 186
Black or African American only, male . . 198 194 192 191 183
Black or African American only, female . 201 199 194 191 189
Asian only . . . . . . . . . . . . . . . . . . . . -- -- -- -- 191
Asian only, male . . . . . . . . . . . . . . -- -- -- -- 190
Asian only, female . . . . . . . . . . . . . -- -- -- -- 192
Hispanic or Latino . . . . . . . . . . . . . . . . -- -- -- 197 193
Hispanic or Latino, male . . . . . . . . . . -- -- -- 199 193
Hispanic or Latina, female. . . . . . . . . -- -- -- 194 193
Mexican origin . . . . . . . . . . . . . . . . . 199 197 198 198 192
Mexican origin, male . . . . . . . . . . . . 199 200 200 200 194
Mexican origin, female . . . . . . . . . . . 198 194 196 195 189
Percent of poverty level: 5
Below 100% . . . . . . . . . . . . . . . . . . 200 198 200 194 189
100%199% . . . . . . . . . . . . . . . . . . 202 202 199 197 190
200%399% . . . . . . . . . . . . . . . . . . 205 204 199 197 193
400% or more . . . . . . . . . . . . . . . . . 206 204 203 198 196
Male
2044 years . . . . . . . . . . . . . . . . . . . . 194 196 196 194 188
2034 years . . . . . . . . . . . . . . . . . . . 186 188 186 186 179
3544 years . . . . . . . . . . . . . . . . . . . 206 207 209 205 202
4564 years . . . . . . . . . . . . . . . . . . . . 216 213 206 202 196
4554 years . . . . . . . . . . . . . . . . . . . 216 215 208 204 200
5564 years . . . . . . . . . . . . . . . . . . . 216 212 202 199 192
6574 years . . . . . . . . . . . . . . . . . . . . 212 202 191 182 180
75 years and over . . . . . . . . . . . . . . . . . 205 195 187 176 168
Female
2044 years . . . . . . . . . . . . . . . . . . . . 189 191 192 187 184
2034 years . . . . . . . . . . . . . . . . . . . 184 185 188 181 179
3544 years . . . . . . . . . . . . . . . . . . . 195 198 197 195 193
4564 years . . . . . . . . . . . . . . . . . . . . 225 215 213 211 209
4554 years . . . . . . . . . . . . . . . . . . . 217 211 208 208 207
5564 years . . . . . . . . . . . . . . . . . . . 235 221 219 214 210
6574 years . . . . . . . . . . . . . . . . . . . . 233 224 214 207 200
75 years and over . . . . . . . . . . . . . . . . . 229 217 206 203 199
NOTES: See Appendix II, Cholesterol. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
1
Estimates are age-adjusted to the year 2000 standard population using four age groups: 2044 years, 4564 years, 6574 years, and 75 years and over. Age-
adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
adjustment procedure. See Appendix II, Age adjustment.
NOTES: Starting in 2001, 24-hour dietary recall data were collected in the mobile examination center (day 1 file) and on a second day by telephone interview (day 2
file). For comparability across survey years, this table is based on day 1 data only. It is recognized that usual intake of macronutrients based on 2 or more days of
dietary data would be more precise (Freedman LS, Guenther PM, Dodd KW, Krebs-Smith SM, Midthune D. The population distribution of ratios of usual intakes of
dietary components that are consumed every day can be estimated from repeated 24-hour recalls. J Nutr 2010 Jan;140(1):1116). Two days of data are available only
in later years of the continuous NHANES survey. Thus, in order to present trends, macronutrient intake estimates on a given day are presented in this table. This table
excludes individuals who reported no energy intake. Energy intake included kilocalories from all foods and beverages, including alcoholic beverages, consumed during
the previous 24-hour period. Macronutrients (carbohydrates, protein, and fat) do not sum to 100% because information for alcohol is not shown in the table. See Health,
United States, 2013, Table 67, for earlier data years. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.
htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. U.S. Department of Agriculture, Agriculture Research Service. Beltsville Human Nutrition Research
Center, Food Surveys Research Group, What We Eat in America. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Percent
18 years and over, age-adjusted 2,3 . . . . . . . 14.3 15.0 20.7 21.5 21.6 56.6 54.7 49.1 46.8 46.8
18 years and over, crude 3 . . . . . . . . . . . . 14.5 15.1 20.4 20.9 20.9 56.3 54.6 49.5 47.5 47.5
Age
1844 years . . . . . . . . . . . . . . . . . . . 18.9 18.9 25.7 26.7 26.4 50.7 49.1 43.1 40.8 40.7
1824 years . . . . . . . . . . . . . . . . . . 23.8 23.8 29.6 31.1 29.8 46.5 44.5 39.4 38.0 37.8
2544 years . . . . . . . . . . . . . . . . . . 17.4 17.3 24.3 25.1 25.2 51.9 50.6 44.4 41.8 41.7
4564 years . . . . . . . . . . . . . . . . . . . 11.4 12.8 17.7 17.8 18.1 58.8 57.6 51.0 50.6 50.5
4554 years . . . . . . . . . . . . . . . . . . 13.2 14.5 19.2 19.3 19.3 56.9 55.4 48.9 49.2 49.0
5564 years . . . . . . . . . . . . . . . . . . 8.6 10.1 15.9 16.1 16.9 61.8 61.0 53.7 52.1 52.2
65 years and over . . . . . . . . . . . . . . . . 5.5 6.8 10.4 11.7 12.7 71.0 67.0 64.6 58.7 58.8
6574 years . . . . . . . . . . . . . . . . . . 7.0 8.4 13.6 14.4 15.5 65.6 60.3 59.9 53.1 52.4
75 years and over. . . . . . . . . . . . . . . 3.5 4.9 6.4 7.9 8.7 77.8 75.0 70.3 66.7 67.8
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . . 17.5 17.9 25.1 25.5 25.3 50.8 49.6 43.8 43.4 43.5
Female. . . . . . . . . . . . . . . . . . . . . . 11.4 12.3 16.5 17.7 18.0 61.9 59.4 54.0 50.0 49.9
Sex and age
Male:
1844 years . . . . . . . . . . . . . . . . . . 23.0 23.0 31.8 32.3 32.1 44.3 43.0 37.1 36.2 36.8
4554 years . . . . . . . . . . . . . . . . . . 16.1 16.0 20.9 21.5 21.6 52.9 52.7 45.2 48.0 47.5
5564 years . . . . . . . . . . . . . . . . . . 9.4 11.3 19.1 17.6 18.9 58.2 58.7 50.1 52.1 50.3
6574 years . . . . . . . . . . . . . . . . . . 9.5 9.4 16.6 17.5 15.7 58.9 55.3 55.6 50.5 48.4
75 years and over. . . . . . . . . . . . . . . 4.9 7.1 9.1 10.7 9.4 69.5 66.7 62.8 60.3 63.2
Female:
1844 years . . . . . . . . . . . . . . . . . . 14.9 15.0 19.6 21.3 20.9 56.9 55.0 49.0 45.2 44.5
4554 years . . . . . . . . . . . . . . . . . . 10.5 13.1 17.5 17.3 17.1 60.8 57.9 52.4 50.3 50.4
5564 years . . . . . . . . . . . . . . . . . . 7.8 9.0 13.1 14.8 15.0 65.0 63.1 57.0 52.2 53.9
6574 years . . . . . . . . . . . . . . . . . . 5.1 7.7 11.0 11.8 15.3 70.9 64.3 63.6 55.4 55.9
75 years and over. . . . . . . . . . . . . . . 2.6 3.6 4.6 5.9 8.2 83.0 80.0 75.3 71.3 71.1
Race 2,4
White only . . . . . . . . . . . . . . . . . . . . 14.8 15.7 21.4 22.1 22.0 55.2 53.1 47.6 45.6 45.7
Black or African American only . . . . . . . . . 11.7 12.2 17.2 19.9 19.8 65.7 64.6 58.5 53.4 54.5
American Indian or Alaska Native only . . . . . 16.0 *10.6 *12.7 24.1 18.8 57.6 67.1 54.0 51.5 47.0
Asian only . . . . . . . . . . . . . . . . . . . . 13.5 14.1 17.8 17.0 19.1 59.1 55.0 51.7 49.9 45.1
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . -- * * * * -- * * * *
2 or more races . . . . . . . . . . . . . . . . . -- 19.0 25.9 21.0 22.7 -- 52.8 45.0 46.1 47.8
Hispanic origin and race 2,4
Hispanic or Latino . . . . . . . . . . . . . . . . 9.4 9.2 14.4 15.3 16.8 67.7 66.5 60.2 55.2 53.5
Mexican . . . . . . . . . . . . . . . . . . . . 8.7 8.1 13.2 14.3 16.4 69.5 67.0 60.7 55.8 55.0
Not Hispanic or Latino. . . . . . . . . . . . . . 14.9 15.8 21.9 22.7 22.6 55.3 53.2 47.2 45.2 45.4
White only. . . . . . . . . . . . . . . . . . . 15.5 16.5 22.9 23.7 23.5 53.6 51.4 45.0 43.3 43.6
Black or African American only . . . . . . . . 11.7 12.2 17.4 20.1 19.9 65.8 64.6 58.4 53.3 54.3
Education 5,6
No high school diploma or GED. . . . . . . . . 4.6 4.3 7.7 7.1 8.1 76.3 74.0 69.8 66.7 67.0
High school diploma or GED . . . . . . . . . . 8.6 9.5 12.7 13.1 13.2 64.6 61.7 59.0 57.2 58.1
Some college or more . . . . . . . . . . . . . . 18.2 18.9 25.0 25.4 25.2 48.0 47.1 42.1 40.4 40.7
See footnotes at end of table.
Percent
18 years and over, age-adjusted 2,3 . . . . . . 40.0 42.2 47.3 50.0 49.8 17.7 18.0 24.4 24.6 25.0
18 years and over, crude 3 . . . . . . . . . . . 40.3 42.4 46.9 49.3 49.0 17.9 18.1 24.0 24.0 24.4
Age
1844 years . . . . . . . . . . . . . . . . . . 45.7 47.7 53.8 56.7 56.4 22.5 22.1 28.8 29.3 29.3
1824 years . . . . . . . . . . . . . . . . . 49.3 52.2 57.2 59.5 59.0 28.0 27.2 32.8 33.8 32.9
2544 years . . . . . . . . . . . . . . . . . 44.6 46.3 52.5 55.7 55.5 20.8 20.5 27.4 27.7 27.9
4564 years . . . . . . . . . . . . . . . . . . 38.2 39.7 45.2 46.2 45.9 14.4 15.5 21.5 21.0 21.8
4554 years . . . . . . . . . . . . . . . . . 40.1 42.1 47.6 47.8 47.9 16.2 17.0 22.6 22.4 22.5
5564 years . . . . . . . . . . . . . . . . . 35.3 36.1 42.1 44.4 43.8 11.5 13.1 20.1 19.4 21.0
65 years and over . . . . . . . . . . . . . . . 26.0 30.1 30.5 36.5 36.6 8.6 9.8 15.4 16.5 17.3
6574 years . . . . . . . . . . . . . . . . . 31.7 36.8 35.9 42.4 43.3 9.7 11.3 17.9 19.0 19.8
75 years and over. . . . . . . . . . . . . . 18.7 22.1 23.9 28.2 27.2 7.2 8.0 12.3 13.0 13.8
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . 45.4 47.4 52.1 53.3 53.0 21.2 20.8 29.1 28.8 28.8
Female. . . . . . . . . . . . . . . . . . . . . 35.1 37.6 42.7 47.0 46.9 14.4 15.4 19.8 20.7 21.2
Sex and age
Male:
1844 years . . . . . . . . . . . . . . . . . 51.5 53.6 59.0 60.8 60.0 27.2 26.3 35.6 35.4 35.2
4554 years . . . . . . . . . . . . . . . . . 44.3 45.2 50.7 48.9 49.3 18.8 18.0 24.8 24.5 25.0
5564 years . . . . . . . . . . . . . . . . . 38.3 38.9 46.0 44.7 46.5 12.9 13.8 22.9 20.7 22.1
6574 years . . . . . . . . . . . . . . . . . 38.5 41.8 40.7 45.6 47.2 12.0 12.2 20.6 21.5 20.1
75 years and over. . . . . . . . . . . . . . 26.1 30.7 32.3 35.2 31.1 9.5 10.1 14.5 15.3 15.0
Female:
1844 years . . . . . . . . . . . . . . . . . 40.0 42.0 48.5 52.7 52.9 17.9 17.9 22.1 23.4 23.5
4554 years . . . . . . . . . . . . . . . . . 36.1 39.1 44.7 46.7 46.6 13.7 16.1 20.4 20.4 20.1
5564 years . . . . . . . . . . . . . . . . . 32.5 33.5 38.6 44.2 41.2 10.3 12.4 17.5 18.3 19.9
6574 years . . . . . . . . . . . . . . . . . 26.2 32.6 31.8 39.7 39.9 7.8 10.5 15.6 16.8 19.5
75 years and over. . . . . . . . . . . . . . 14.0 16.8 18.3 23.2 24.4 5.7 6.7 10.8 11.4 12.9
Race 2,4
White only . . . . . . . . . . . . . . . . . . . 41.5 44.1 48.9 51.3 51.0 18.0 18.5 24.8 25.2 25.3
Black or African American only . . . . . . . . 30.4 31.7 37.3 43.6 42.0 15.6 16.0 21.4 23.1 23.5
American Indian or Alaska Native only . . . . 39.7 29.7 42.0 44.1 46.9 18.2 13.9 16.7 27.9 24.4
Asian only . . . . . . . . . . . . . . . . . . . 37.1 41.7 44.2 47.5 51.4 17.2 17.2 21.9 19.5 22.6
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . -- * * * * -- * * * *
2 or more races . . . . . . . . . . . . . . . . -- 43.9 50.2 50.5 49.0 -- 22.2 30.4 24.8 26.3
Hispanic origin and race 2,4
Hispanic or Latino . . . . . . . . . . . . . . . 29.1 30.8 36.2 41.3 43.3 12.7 11.9 18.1 19.0 20.0
Mexican . . . . . . . . . . . . . . . . . . . 27.4 30.0 35.9 40.6 42.3 11.9 11.3 16.7 18.1 19.2
Not Hispanic or Latino. . . . . . . . . . . . . 41.3 43.7 49.1 51.7 51.2 18.3 18.8 25.5 25.8 26.0
White only. . . . . . . . . . . . . . . . . . 43.1 45.7 51.5 53.7 53.1 18.7 19.3 26.3 26.7 26.7
Black or African American only . . . . . . . 30.4 31.7 37.3 43.6 42.1 15.6 16.0 21.6 23.3 23.7
Education 5,6
No high school diploma or GED. . . . . . . . 21.4 23.9 27.1 31.2 30.1 7.0 6.6 10.9 9.3 11.0
High school diploma or GED . . . . . . . . . 32.6 35.7 37.3 39.7 39.0 11.4 12.1 16.2 16.2 16.2
Some college or more . . . . . . . . . . . . . 48.1 49.4 53.9 56.1 55.5 22.1 22.4 28.9 28.9 29.0
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Starting with Health, United States, 2010, measures of physical activity shown in this table changed to reflect the federal 2008 Physical Activity Guidelines for Americans
(available from: http://www.health.gov/PAGuidelines/). This table presents four measures of physical activity that are of interest to the public health community: the
percentage of adults who met the federal 2008 guidelines for both aerobic activity and muscle strengthening; the percentage who met neither the aerobic activity
guideline nor the muscle-strengthening guideline; the percentage who met the aerobic activity guideline; and the percentage who met the muscle-strengthening
guideline. Persons who met neither the aerobic activity nor the muscle-strengthening guideline were unable to be active, were completely inactive, or had some
aerobic or muscle-strengthening activities but amounts were insufficient to meet the guidelines. The percentage of persons who met the aerobic activity guideline
includes those who may or may not have also met the muscle-strengthening guideline. Similarly, the percentage of persons who met the muscle-strengthening
guideline includes those who may or may not have also met the aerobic activity guideline. The federal 2008 guidelines recommend that for substantial health benefits
adults perform at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic
physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10
minutes, and preferably should be spread throughout the week. The 2008 guidelines also recommend that adults perform muscle-strengthening activities that are
moderate or high intensity and involve all major muscle groups on 2 or more days a week, because these activities provide additional health benefits. See Appendix II,
Physical activity, leisure-time.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years, 6574 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
3
Includes all other races not shown separately, unknown education level, and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data (shown in spreadsheet version), race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the
only race responses. Almost all persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 2544 years, 4554 years, 5564 years,
6574 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Sex, age, race Overweight or obese (BMI greater than or equal to 25.0) 2
and Hispanic origin 1,
and percent of poverty level 19881994 19992002 20032006 20072010 20112014
Sex, age, race Grade 3 Obesity (BMI greater than or equal to 40.0) 2
and Hispanic origin 1,
and percent of poverty level 19881994 19992002 20032006 20072010 20112014
NOTES: Percents do not sum to 100 because the percentage of persons with BMI less than normal weight (18.5 kilograms per meters squared) is not shown and the
percentage of persons with obesity is a subset of the percentage with overweight. Height was measured without shoes. Excludes pregnant women.
See Health, United States, 2013, Table 69, for earlier data years. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
NOTES: Obesity is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile from the 2000 CDC Growth Charts: United States.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC Growth Charts for the United States:
methods and development. Vital Health Stat 11. 2002 May;(246):1190. Available at: http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf. In Health, United States
the NHANES variable, Body Mass Index, is used to assign persons to BMI categories. Age is at time of examination at the mobile examination center. Crude rates,
not age-adjusted rates, are shown. Height was measured without shoes. Excludes pregnant females. See Health, United States, 2013, Table 70, for earlier data years.
Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are
available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data for 19881994 have been revised and differ from
previous editions.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
NOTES: Untreated dental caries refers to decay on the crown or enamel surface of a tooth (i.e., coronal caries) that has not been treated or filled. Decay in the root (i.e.,
root caries) was not included. The presence of caries was evaluated in primary and permanent teeth for persons aged 5 and older. The third molars were not included.
Persons without at least one natural tooth (primary or permanent) were classified as edentulous (without any teeth) and were excluded. The majority of edentulous
persons are aged 65 and over. Estimates of edentulism among persons aged 65 and over are 33% in 19881994, 23% in 20052008, and 17% in 20112014. Over
time, there have been changes in the NHANES oral health examination process, ages examined, and methodology. Therefore, data trends need to be interpreted
with caution. For more information on the methodology changes, see Appendix II, Dental caries. Standard errors are available in the spreadsheet version of this table.
Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Persons who report the emergency department as their usual source of care are defined as having no usual source of care. See Appendix II, Usual source of care.
3
Includes all other races not shown separately and unknown health insurance status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed starting in 1993. See Appendix II, Family income; Poverty; Table VI.
6
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Medicaid
includes other public assistance through 1996. Starting with 1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999
data, coverage by the Children's Health Insurance Program (CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also
includes military, other government, and Medicare coverage. Persons not covered by private insurance, Medicaid, CHIP, public assistance (through 1996), state-
sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons
with only Indian Health Service coverage are considered to have no health insurance coverage. Health insurance status was unknown for 8%9% of children in
19931996 and about 1% in 19972015. See Appendix II, Health insurance coverage.
7
MSA is metropolitan statistical area. Starting with 20052006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For
data prior to 2005, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, access to care and health insurance supplements (19931996). Starting in 1997, data are from the family core and
sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Persons who report the emergency department as their usual source of care are defined as having no usual source of care. See Appendix II, Usual source of care.
3
Includes all other races not shown separately, unknown health insurance status, and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data (shown in spreadsheet version), race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the
only race responses. Almost all persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed starting in 1993. See Appendix II, Family income; Poverty; Table VI.
6
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Medicaid
includes other public assistance through 1996. Starting with 1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999
data, coverage by the Children's Health Insurance Program (CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also
includes military, other government, and Medicare coverage. Persons not covered by private insurance, Medicaid, CHIP, public assistance (through 1996), state-
sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons
with only Indian Health Service coverage are considered to have no health insurance coverage. In 19931996, health insurance status was unknown for 8%9% of
adults in the sample. In 19972015, health insurance status was unknown for about 1% of adults aged 1864. See Appendix II, Health insurance coverage.
7
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
8
MSA is metropolitan statistical area. Starting with 20052006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For
data prior to 2005, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, access to care and health insurance supplements (19931996). Starting in 1997, data are from the family core and
sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2005 2010 2015 1997 2005 2010 2015 1997 2005 2010 2015
Percent
Total 4 . . . . . . . . . . . . . . . . . . 8.3 8.5 10.9 7.3 4.8 7.2 8.3 5.2 8.6 10.7 13.5 9.4
Age
Under 19 years . . . . . . . . . . . . . 4.5 4.3 4.5 2.8 2.1 3.0 2.8 1.6 6.0 7.3 6.6 4.1
Under 18 years . . . . . . . . . . . . . 4.4 4.2 4.4 2.7 2.2 2.9 2.7 1.6 6.0 7.3 6.6 4.1
Under 6 years . . . . . . . . . . . . . 3.3 3.3 3.7 2.2 1.6 2.5 2.5 1.4 3.9 3.7 3.9 1.9
617 years . . . . . . . . . . . . . . 4.9 4.7 4.8 2.9 2.4 3.1 2.8 1.7 6.8 8.4 7.5 4.9
1864 years . . . . . . . . . . . . . . . 10.7 11.0 14.7 9.8 6.3 9.4 11.2 6.9 10.6 13.0 17.3 11.8
1844 years . . . . . . . . . . . . . . 11.0 11.3 14.5 9.5 6.9 9.8 11.2 6.2 11.7 14.1 17.9 11.6
1824 years . . . . . . . . . . . . 10.2 11.3 13.5 7.5 6.7 9.6 9.7 4.5 11.6 13.7 17.4 9.4
2534 years . . . . . . . . . . . . 11.4 11.8 15.3 10.3 6.9 10.2 12.0 6.6 12.3 15.1 18.3 12.4
3544 years . . . . . . . . . . . . 11.0 10.8 14.4 10.1 7.1 9.6 11.3 6.9 11.2 13.3 17.8 12.4
1925 years . . . . . . . . . . . . . . 11.1 12.5 14.8 8.4 7.7 10.3 10.9 5.5 13.1 14.8 18.9 10.9
4564 years . . . . . . . . . . . . . . 10.1 10.6 14.9 10.3 5.1 8.7 11.3 8.0 8.4 11.5 16.5 12.1
4554 years . . . . . . . . . . . . 10.6 10.8 15.0 10.3 5.6 9.2 11.5 8.0 9.4 12.1 17.8 12.1
5564 years . . . . . . . . . . . . 9.3 10.4 14.6 10.2 4.2 8.0 11.0 8.0 7.0 10.7 14.9 12.2
65 years and over . . . . . . . . . . . . 4.6 4.6 5.0 4.1 2.8 5.1 4.7 3.9 3.5 5.2 6.9 7.0
6574 years . . . . . . . . . . . . . . 5.0 5.4 6.3 4.9 3.4 6.4 6.3 4.8 4.2 6.2 9.0 7.8
75 years and over. . . . . . . . . . . 4.1 3.7 3.4 3.0 2.0 3.6 2.8 2.8 2.6 4.0 4.3 5.8
1864 years
Sex
Male . . . . . . . . . . . . . . . . . . . 9.3 10.0 13.5 8.9 5.1 7.2 8.8 5.4 8.8 10.8 15.2 10.0
Female. . . . . . . . . . . . . . . . . . 12.0 12.1 15.7 10.7 7.4 11.4 13.5 8.4 12.4 15.2 19.4 13.6
Race 5
White only . . . . . . . . . . . . . . . . 10.8 11.1 14.5 9.9 5.9 9.1 10.8 6.5 10.6 12.8 17.1 11.7
Black or African American only . . . . . 10.8 12.0 17.4 11.0 9.5 11.6 15.6 10.1 10.8 15.2 20.7 13.6
American Indian or Alaska Native only . 14.5 13.2 *15.7 9.8 *10.1 *14.1 18.6 *13.4 18.8 19.2 23.1 17.7
Asian only . . . . . . . . . . . . . . . . 6.3 5.0 8.0 4.8 *2.8 *3.5 4.2 3.4 7.8 6.8 8.7 7.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . -- 19.9 24.0 15.2 -- 22.9 16.6 10.9 -- 23.0 25.6 14.3
Hispanic origin and race 5
Hispanic or Latino . . . . . . . . . . . . 10.5 11.5 15.4 10.8 6.7 11.2 13.0 8.3 11.5 15.5 21.6 14.5
Mexican . . . . . . . . . . . . . . . . 9.7 11.4 15.6 11.0 6.5 12.0 13.5 8.6 11.3 16.3 22.0 16.0
Not Hispanic or Latino. . . . . . . . . . 10.7 11.0 14.5 9.6 6.3 9.0 10.9 6.6 10.5 12.6 16.6 11.3
White only. . . . . . . . . . . . . . . 10.9 11.1 14.3 9.7 5.9 8.7 10.3 6.1 10.5 12.3 16.2 11.1
Black or African American only . . . . 10.8 12.0 17.5 11.1 9.5 11.4 15.6 10.2 10.8 15.3 20.8 13.7
Education 6
No high school diploma or GED. . . . . 16.2 16.2 20.6 14.0 11.5 16.4 18.1 13.9 14.5 20.3 26.3 20.3
High school diploma or GED . . . . . . 11.1 11.7 16.1 11.4 7.0 10.5 13.8 9.2 11.4 14.6 20.1 14.2
Some college or more . . . . . . . . . . 9.2 9.8 13.4 9.2 4.3 7.1 9.2 5.6 8.8 10.4 14.4 10.2
Percent of poverty level 7
Below 100% . . . . . . . . . . . . . . . 19.6 20.0 23.4 16.6 14.8 19.5 21.5 12.9 19.4 24.4 30.4 21.2
100%199%. . . . . . . . . . . . . . . 17.9 18.9 24.0 15.9 11.6 16.3 18.4 12.7 18.3 21.0 29.2 20.9
200%399%. . . . . . . . . . . . . . . 10.5 11.8 15.2 10.8 5.5 9.5 11.4 7.0 10.2 13.7 17.3 12.9
400% or more . . . . . . . . . . . . . . 4.6 5.0 6.8 4.2 1.7 3.3 3.9 2.3 4.5 5.9 7.0 4.0
See footnotes at end of table.
Characteristic 1997 2005 2010 2015 1997 2005 2010 2015 1997 2005 2010 2015
Characteristic 1997 2005 2010 2015 1997 2005 2010 2015 1997 2005 2010 2015
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Based on persons responding to the questions, "During the past 12 months was there any time when person needed medical care but did not get it because person
couldn't afford it?" and "During the past 12 months has medical care been delayed because of worry about the cost?"
2
Based on persons responding to the question, "During the past 12 months was there any time when person needed prescription medicine but didn't get it because
person couldn't afford it?"
3
Based on persons responding to the question, "During the past 12 months was there any time when person needed dental care (including checkups) but didn't get it
because person couldn't afford it?"
4
Includes all other races not shown separately, unknown health insurance status, unknown education level, and unknown disability status.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
6
Estimates are for persons aged 2564. GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
For information on the health insurance categories, see Appendix II, Health insurance coverage.
9
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
10
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors and additional data years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core, sample child, and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Respondents were asked how many times a doctor or other health care professional was seen in the past 12 months at a doctor's office, clinic, or some other place.
Excluded are visits to emergency rooms, hospitalizations, home visits, and telephone calls. Starting with 2000 data, dental visits were also excluded. See Appendix II,
Health care contact.
2
Includes all other races not shown separately and unknown health insurance status.
3
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
4
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed starting in 1997. See Appendix II, Family income; Poverty; Table VI.
5
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with
1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children's Health Insurance Program
(CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other government, and Medicare coverage.
Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans
are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See
Appendix II, Health insurance coverage.
6
MSA is metropolitan statistical area. Starting with 20052006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For
data prior to 2005, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015 1997 2010 2015
Percent distribution
Total, age-adjusted 2,3 . . . . . . . . . . . 16.5 15.6 15.0 46.2 45.4 48.4 23.6 25.8 23.7 13.7 13.2 12.8
Total, crude 2. . . . . . . . . . . . . . . . 16.5 15.4 14.6 46.5 45.2 47.8 23.5 26.0 24.1 13.5 13.5 13.5
Age
Under 18 years . . . . . . . . . . . . . . 11.8 8.1 7.9 54.1 55.6 59.7 25.2 28.2 25.7 8.9 8.2 6.7
Under 6 years . . . . . . . . . . . . . . 5.0 3.7 4.7 44.9 48.9 52.2 37.0 36.8 35.7 13.0 10.6 7.5
617 years . . . . . . . . . . . . . . . 15.3 10.4 9.5 58.7 59.1 63.3 19.3 23.6 20.9 6.8 6.9 6.4
1844 years . . . . . . . . . . . . . . . . 21.7 24.2 23.3 46.7 43.9 46.9 19.0 20.6 18.7 12.6 11.3 11.1
1824 years . . . . . . . . . . . . . . . 22.0 25.9 24.5 46.8 43.4 47.2 20.0 21.1 19.6 11.2 9.6 8.8
2544 years . . . . . . . . . . . . . . . 21.6 23.6 22.9 46.7 44.1 46.8 18.7 20.5 18.3 13.0 11.9 11.9
4564 years . . . . . . . . . . . . . . . . 16.9 14.8 13.7 42.9 42.8 45.5 24.7 26.1 24.5 15.5 16.4 16.3
4554 years . . . . . . . . . . . . . . . 17.9 17.6 16.1 43.9 43.5 47.0 23.4 23.9 23.3 14.8 15.0 13.6
5564 years . . . . . . . . . . . . . . . 15.3 11.1 11.2 41.3 41.9 43.8 26.7 28.8 25.9 16.7 18.2 19.1
65 years and over . . . . . . . . . . . . . 8.9 5.3 5.5 34.7 33.8 35.5 32.5 36.7 33.9 23.8 24.2 25.1
6574 years . . . . . . . . . . . . . . . 9.8 6.3 6.4 36.9 36.1 37.9 31.6 35.7 33.7 21.6 21.9 22.0
75 years and over. . . . . . . . . . . . 7.7 4.1 4.2 31.8 31.0 32.0 33.8 38.0 34.2 26.6 27.0 29.6
Sex 3
Male . . . . . . . . . . . . . . . . . . . . 21.3 20.4 19.5 47.1 46.4 49.8 20.6 22.7 20.3 11.0 10.5 10.5
Female. . . . . . . . . . . . . . . . . . . 11.8 10.9 10.8 45.4 44.4 47.1 26.5 28.8 26.9 16.3 15.9 15.2
Race 3,4
White only . . . . . . . . . . . . . . . . . 16.0 15.3 14.8 46.1 44.9 47.8 23.9 26.1 24.0 14.0 13.7 13.4
Black or African American only . . . . . . 16.8 15.7 14.5 46.1 47.2 50.2 23.2 24.7 24.1 13.9 12.4 11.2
American Indian or Alaska Native only . . 17.1 19.4 20.6 38.0 40.3 39.0 24.2 28.1 23.3 20.7 12.2 17.1
Asian only . . . . . . . . . . . . . . . . . 22.8 20.4 18.2 49.1 49.9 54.7 19.7 22.1 18.7 8.3 7.6 8.5
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . -- * * -- * * -- * * -- * *
2 or more races . . . . . . . . . . . . . . -- 13.9 17.3 -- 42.3 41.5 -- 25.2 25.0 -- 18.6 16.2
Hispanic origin and race 3,4
Hispanic or Latino . . . . . . . . . . . . . 24.9 23.5 22.3 42.3 43.2 45.9 20.3 22.6 21.9 12.5 10.7 9.9
Mexican . . . . . . . . . . . . . . . . . 28.9 25.2 24.8 40.8 43.3 44.8 18.5 21.4 20.7 11.8 10.1 9.7
Not Hispanic or Latino. . . . . . . . . . . 15.4 14.0 13.4 46.7 45.8 49.0 24.0 26.5 24.1 13.9 13.7 13.5
White only. . . . . . . . . . . . . . . . 14.7 13.2 12.7 46.6 45.3 48.1 24.4 27.1 24.7 14.3 14.4 14.5
Black or African American only . . . . . 16.9 15.6 14.7 46.1 47.3 50.5 23.1 24.9 23.8 13.8 12.2 11.0
Percent of poverty level 3,5
Below 100% . . . . . . . . . . . . . . . . 20.6 20.4 19.0 37.8 37.5 39.9 22.7 25.1 23.9 18.9 17.0 17.1
100%199%. . . . . . . . . . . . . . . . 20.1 20.8 18.4 43.3 42.1 45.1 21.7 23.1 22.9 14.9 13.9 13.6
200%399%. . . . . . . . . . . . . . . . 16.4 16.2 15.9 47.2 46.3 49.5 23.6 25.4 22.8 12.8 12.1 11.8
400% or more . . . . . . . . . . . . . . . 12.8 10.2 11.2 49.8 49.4 51.8 24.9 27.6 24.7 12.5 12.7 12.3
See footnotes at end of table.
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015 1997 2010 2015
NOTES: Standard errors are available in the spreadsheet version of this table. Available from http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
American Native
Black or Indian or Hawaiian or At or Inside MSA 3
African Alaska Other Pacific 2 or Below above
White American Native Asian Islander more Hispanic poverty poverty Central Remaining Outside
Vaccination and year All only only only only 4 only 4 races or Latino level level city area MSA 3
2009 . . . . . . . . . . . . . . . 44.3 45.2 39.6 * 38.6 * 40.7 45.9 41.3 45.7 44.8 44.6 42.4
2010 . . . . . . . . . . . . . . . 56.6 56.9 54.5 64.1 59.3 * 61.3 55.5 52.8 58.7 56.5 57.2 55.2
2011 . . . . . . . . . . . . . . . 68.5 68.8 63.7 65.9 70.8 * 70.9 69.5 63.6 71.6 69.5 67.9 67.4
2012 . . . . . . . . . . . . . . . 68.4 69.3 64.8 * 71.6 * 71.5 67.8 63.4 71.6 67.6 69.4 68.0
2013 . . . . . . . . . . . . . . . 70.4 72.1 65.0 70.1 72.7 * 71.8 69.3 64.4 73.8 68.8 72.5 69.1
2014 . . . . . . . . . . . . . . . 71.6 72.6 65.4 * 69.5 * 68.5 74.3 65.7 75.4 70.8 72.7 71.2
2015 . . . . . . . . . . . . . . . 72.2 72.7 69.1 68.2 77.9 * 73.7 71.7 68.7 74.7 72.5 72.5 70.2
DTP/DT/DTaP (4 doses or
more): 6
2000 . . . . . . . . . . . . . . . 81.7 84.4 76.1 77.8 84.5 * 81.5 78.6 76.2 83.5 79.9 82.8 82.9
2005 . . . . . . . . . . . . . . . 85.7 87.1 84.0 * 88.8 * 86.3 83.6 81.8 87.4 84.8 87.0 84.7
2009 . . . . . . . . . . . . . . . 83.9 85.8 78.6 82.1 86.6 93.1 81.8 82.9 80.1 85.7 83.8 84.2 84.2
2010 . . . . . . . . . . . . . . . 84.4 84.5 83.7 81.8 88.3 * 82.8 84.4 80.8 86.1 84.0 85.0 83.7
2011 . . . . . . . . . . . . . . . 84.6 85.0 81.3 72.7 92.0 93.0 87.1 84.1 81.0 86.8 86.1 83.8 82.2
2012 . . . . . . . . . . . . . . . 82.5 83.6 79.6 88.2 88.1 * 85.6 80.8 78.5 85.0 82.4 83.4 80.5
2013 . . . . . . . . . . . . . . . 83.1 85.3 74.7 78.1 89.0 * 83.1 82.3 77.8 86.0 81.8 84.7 82.4
2014 . . . . . . . . . . . . . . . 84.2 85.5 79.1 * 87.4 * 79.6 85.4 79.1 87.4 83.6 85.3 83.1
2015 . . . . . . . . . . . . . . . 84.6 85.2 82.0 79.6 90.0 * 82.5 84.5 80.2 87.1 85.4 84.3 82.7
Polio (3 doses or more):
2000 . . . . . . . . . . . . . . . 89.5 90.6 86.6 90.8 92.7 91.2 91.2 87.9 86.9 89.9 88.1 90.1 91.1
2005 . . . . . . . . . . . . . . . 91.7 91.4 91.0 * 92.9 * 93.8 92.3 89.7 92.4 90.6 92.6 92.2
2009 . . . . . . . . . . . . . . . 92.8 93.3 90.9 92.2 94.0 97.3 92.8 92.5 92.0 93.3 93.5 92.1 92.1
2010 . . . . . . . . . . . . . . . 93.3 93.2 94.0 94.6 92.8 95.1 90.2 93.8 92.4 93.6 92.7 94.1 93.1
2011 . . . . . . . . . . . . . . . 93.9 93.9 93.9 88.1 96.5 96.6 93.5 93.8 93.6 94.2 94.3 93.4 94.2
2012 . . . . . . . . . . . . . . . 92.8 93.0 92.9 95.2 92.3 * 93.3 92.5 91.8 93.4 92.6 92.9 92.8
2013 . . . . . . . . . . . . . . . 92.7 93.7 91.2 92.2 95.5 * 90.8 91.6 89.2 94.4 91.9 93.2 93.4
2014 . . . . . . . . . . . . . . . 93.3 93.3 92.0 93.8 93.2 93.8 94.0 93.8 92.0 94.5 92.7 94.2 92.7
2015 . . . . . . . . . . . . . . . 93.7 93.1 93.3 91.8 96.9 92.8 92.4 94.5 91.8 94.6 93.9 94.0 91.7
Measles, Mumps, Rubella:
2000 . . . . . . . . . . . . . . . 90.5 91.6 87.7 89.4 89.3 94.5 88.1 90.0 88.9 90.9 89.7 91.0 90.8
2005 . . . . . . . . . . . . . . . 91.5 91.4 91.9 89.7 91.9 90.3 93.7 91.1 89.3 92.1 91.6 91.8 90.4
2009 . . . . . . . . . . . . . . . 90.0 90.8 88.2 94.9 90.7 96.9 88.5 89.3 88.8 90.6 91.1 88.6 88.6
2010 . . . . . . . . . . . . . . . 91.5 90.6 92.1 93.4 91.7 96.9 89.7 92.9 91.3 91.4 92.4 90.5 91.4
2011 . . . . . . . . . . . . . . . 91.6 91.1 90.8 94.8 93.9 98.7 91.1 92.4 91.3 91.7 92.0 91.2 91.5
2012 . . . . . . . . . . . . . . . 90.8 90.9 90.9 92.0 89.8 * 92.3 90.7 89.9 91.4 90.1 91.0 92.4
2013 . . . . . . . . . . . . . . . 91.9 91.5 90.9 96.3 96.7 90.4 91.5 92.1 90.5 92.5 91.5 92.4 91.3
2014 . . . . . . . . . . . . . . . 91.5 91.2 90.3 96.5 95.7 95.7 90.5 91.9 89.5 92.8 91.9 91.2 91.2
2015 . . . . . . . . . . . . . . . 91.9 91.8 90.7 88.5 92.5 92.0 93.0 92.3 90.3 92.9 92.4 91.7 90.7
Hib (full series): 7
2009 . . . . . . . . . . . . . . . 54.8 55.3 51.2 * 54.6 * 53.7 55.4 51.4 56.5 55.5 54.9 53.0
2010 . . . . . . . . . . . . . . . 66.8 67.5 65.4 77.1 69.5 * 70.1 64.8 61.3 69.7 66.5 68.4 63.4
2011 . . . . . . . . . . . . . . . 80.4 81.0 74.6 73.7 83.5 * 82.0 81.6 75.5 83.4 81.4 80.3 77.8
2012 . . . . . . . . . . . . . . . 80.9 82.2 77.5 84.7 86.1 * 82.5 79.5 76.4 84.0 80.5 81.8 79.9
2013 . . . . . . . . . . . . . . . 82.0 84.2 74.9 82.9 82.0 * 84.9 80.9 75.8 85.3 80.6 84.3 79.7
2014 . . . . . . . . . . . . . . . 82.0 83.8 75.2 83.8 83.1 * 78.7 82.8 76.3 85.5 81.4 82.7 81.6
2015 . . . . . . . . . . . . . . . 82.7 83.0 78.9 81.4 87.0 * 82.4 83.0 78.1 85.5 82.3 83.6 80.9
See footnotes at end of table.
American Native
Black or Indian or Hawaiian or At or Inside MSA 3
African Alaska Other Pacific 2 or Below above
White American Native Asian Islander more Hispanic poverty poverty Central Remaining Outside
Vaccination and year All only only only only 4 only 4 races or Latino level level city area MSA 3
At or At or At or
Below above Below above Below above
Vaccination poverty poverty poverty poverty poverty poverty
and year level 2 level 2 level 2 level 2 level 2 level 2
Federal Data on Race and Ethnicity. Estimates for earlier years were tabulated using the 1977 Standards on Race and Ethnicity. See Appendix II, Hispanic origin; Race.
2
Poverty level is based on family income and family size using U.S. Census Bureau poverty thresholds. In 2015, 3.5% of the 15,167 children with provider-reported
vaccination history data, 5.8% of Hispanic, 2.3% of non-Hispanic white, and 5.9% of non-Hispanic black children, were missing information about poverty level and
were omitted from the estimates of vaccination coverage by poverty level (unweighted percentages). See Appendix II, Family income; Poverty. See Appendix I, National
3
MSA is metropolitan statistical area. See Appendix II, Metropolitan statistical area (MSA).
4
Prior to data year 2000, the category Asian included Native Hawaiian or Other Pacific Islander.
5
The combined 7-vaccine series consists of 4 or more doses of either the diphtheria, tetanus toxoids, and pertussis vaccine (DTP), the diphtheria and tetanus toxoids
vaccine (DT), or the diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP); 3 or more doses of any poliovirus vaccine; 1 or more doses of a
measles-containing vaccine (MCV); 3 or more doses or 4 or more doses of Haemophilus influenzae type b vaccine (Hib) depending on Hib vaccine product type (full
series Hib); 3 or more doses of hepatitis B vaccine; 1 or more doses of varicella vaccine; and 4 or more doses of pneumococcal conjugate vaccine (PCV). The vaccine
shortage that ended in September 2004 might have reduced coverage with the fourth dose of PCV among children in the 2007 National Immunization Survey (NIS)
6
Includes the diphtheria, tetanus toxoids, and pertussis vaccine (DTP), the diphtheria and tetanus toxoids vaccine (DT), and the diphtheria, tetanus toxoids, and
7
Haemophilus influenzae type b vaccine (Hib) full series includes primary series plus the booster dose. Before January 2009, NIS did not distinguish between Hib
vaccine product types; therefore, children who received 3 doses of a vaccine product that requires 4 doses were misclassified as fully vaccinated. In addition, there
was a Hib vaccine shortage during December 2007September 2009. For more information, see Changes in measurement of Haemophilus influenzae serotype b (Hib)
vaccination coverageNational Immunization Survey, United States, 2009. MMWR 59(33);1069-72. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a3.htm?s_cid=mm5933a3_e%0d%0a.
8
Recommended in 1996. Data collection for varicella began in July 1996.
9
PCV is pneumococcal conjugate vaccine. Recommended in 2000. Data collection for PCV began in July 2001. Data for 4 doses of PCV are not available prior to 2005.
10
Rotavirus vaccine includes 2 or more or 3 or more doses, depending on the product type received. Recommended in 2006. Data collection for rotavirus began in 2009.
NOTES: Final estimates from the National Immunization Survey include an adjustment for children with missing immunization provider data. Additional information on
childhood immunizations is available from: http://www.cdc.gov/vaccines/schedules/index.html. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS and National Center for Immunization and Respiratory Diseases (NCIRD) (data for 19982014); NCIRD (data for 2015 onwards), National Immunization
Survey. Available from: https://www.cdc.gov/vaccines/imz-managers/nis/index.html. See Appendix I, National Immunization Survey (NIS).
NOTES: Vaccination coverage estimates are based on provider-verified responses from parents who live in households with telephones. Complex statistical methods
are used to adjust vaccination estimates to account for adolescents whose parents refuse to participate in the survey, for adolescents who live in households without
telephones, or for adolescents whose vaccination histories cannot be verified through their providers. Starting in 2011, the NIS sampling frame was expanded from a
single-landline frame to dual-landline and cellular telephone sampling frames. See Appendix I, National Immunization Survey (NIS). Detailed vaccination data among
adolescents, by race and Hispanic origin, percent of poverty level, and MSA were not available prior to 2008. Interpretation of vaccination data needs to take into
account when specific vaccines were licensed and recommended for use among adolescents. Quadrivalent HPV vaccine was licensed by the U.S. Food and Drug
Administration (FDA) in June 2006. For the initial recommendations on HPV vaccination, see: CDC. Quadrivalent human papillomavirus vaccine: Recommendations
of the Advisory Committee on Immunization Practices. MMWR 2007;56(RR-02):124. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5602a1.htm?s_
cid=rr5602a1_e; HPV vaccine was recommended for males in October 2011. CDC. Recommendations on the use of quadrivalent human papillomavirus vaccine in
males - Advisory Committee on Immunization Practices (ACIP), 2011. MMWR 2011;60(50):17058. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm. Meningococcal vaccine was licensed for use by the FDA in January 2005. For the initial
recommendations on meningococcal vaccination, see: CDC. Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on
Immunization Practices. MMWR 2005;54(RR-07):121. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5407a1.htm. Tdap vaccines were licensed by
the FDA in May and June of 2005. For the initial recommendations on Tdap vaccination, see: CDC. Preventing tetanus, diphtheria, and pertussis among adolescents:
Use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines. Recommendations of the Advisory Committee on Immunization Practices. MMWR
2006;55(RR-03):134. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5503a1.htm. See Appendix I, National Immunization Survey (NIS). Additional
information on the recommended schedule for adolescent vaccination is available from: http://www.cdc.gov/vaccines/schedules/index.html.
SOURCE: NCHS and National Center for Immunization and Respiratory Diseases (NCIRD) (data for 20082014); NCIRD (data for 2015 onwards), National Immunization
SurveyTeen. Available from: https://www.cdc.gov/vaccines/vaxview/index.html. See Appendix I, National Immunization Survey (NIS).
Characteristic 1989 1995 2000 2005 2010 2012 2013 2014 2015
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . 8.5 21.5 26.7 18.4 31.3 33.4 37.0 37.9 39.2
Female. . . . . . . . . . . . . . . . . . . . . . . . 9.7 24.4 30.0 24.2 40.0 41.7 44.7 46.1 46.8
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . 9.6 23.7 30.1 22.5 36.9 38.7 42.2 43.4 44.2
Black or African American only . . . . . . . . . . . 6.4 19.0 19.8 15.5 28.1 30.6 33.0 34.1 35.7
American Indian or Alaska Native only . . . . . . . 10.9 *16.5 31.1 16.2 36.3 37.2 37.9 42.6 39.3
Asian only . . . . . . . . . . . . . . . . . . . . . . 4.3 20.0 27.0 16.9 38.6 40.9 43.9 45.0 47.0
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . . --- --- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . . --- --- 25.3 15.9 28.9 30.1 34.7 34.3 40.8
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . . . . 5.9 16.1 17.7 12.0 26.5 28.1 28.9 31.0 31.2
Mexican . . . . . . . . . . . . . . . . . . . . . . 5.2 16.0 16.6 10.9 25.1 26.8 29.2 31.2 30.4
Not Hispanic or Latino. . . . . . . . . . . . . . . . 9.4 23.7 29.8 22.8 37.3 39.4 43.1 44.2 45.4
White only. . . . . . . . . . . . . . . . . . . . . 9.9 24.6 31.4 24.3 38.8 40.9 44.9 46.0 46.9
Black or African American only . . . . . . . . . . 6.4 19.2 19.9 15.6 28.0 30.9 33.2 34.4 36.0
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . . . . . . . 8.9 20.6 23.1 16.9 25.0 29.2 30.1 32.0 33.6
100%199%. . . . . . . . . . . . . . . . . . . . . 11.5 23.4 28.1 22.0 31.3 32.3 35.5 36.7 37.0
200%399%. . . . . . . . . . . . . . . . . . . . . 8.0 22.8 29.6 22.9 34.8 36.8 40.1 40.8 41.2
400% or more . . . . . . . . . . . . . . . . . . . . 9.0 24.3 29.2 21.3 42.7 44.5 48.6 49.7 50.4
Hispanic origin and race and
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . 5.1 13.3 14.5 9.5 21.9 25.4 25.8 26.8 29.9
100%199% . . . . . . . . . . . . . . . . . . . 7.5 17.8 15.8 11.9 23.3 25.7 25.4 29.6 27.7
200%399% . . . . . . . . . . . . . . . . . . . 6.3 15.7 19.3 11.8 27.5 28.6 29.4 30.8 30.0
400% or more . . . . . . . . . . . . . . . . . . 6.0 19.8 22.2 15.5 36.4 35.5 37.6 39.8 40.0
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . 10.6 23.9 27.8 20.6 26.5 31.3 32.4 35.1 34.9
100%199% . . . . . . . . . . . . . . . . . . 13.2 25.6 33.1 27.4 35.0 35.8 40.7 41.2 41.7
200%399% . . . . . . . . . . . . . . . . . . 8.3 23.8 32.5 26.3 37.5 38.9 42.9 44.0 44.4
400% or more . . . . . . . . . . . . . . . . . 9.4 25.5 30.5 22.4 43.8 46.2 50.4 51.3 52.2
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . 7.5 19.8 20.0 17.0 24.0 27.7 28.3 29.4 30.2
100%199% . . . . . . . . . . . . . . . . . . 6.4 18.8 21.3 15.4 28.6 29.9 30.9 33.0 33.9
200%399% . . . . . . . . . . . . . . . . . . 6.9 20.4 19.5 15.1 27.4 31.8 35.2 34.6 36.1
400% or more . . . . . . . . . . . . . . . . . 5.6 15.6 19.2 15.3 32.9 34.2 38.2 41.6 43.3
See footnotes at end of table.
Characteristic 1989 1995 2000 2005 2010 2012 2013 2014 2015
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Questions concerning use of influenza vaccination differed slightly on the National Health Interview Survey across the years. See Appendix II, Vaccination. Data prior to
1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 1844 years, 4564 years, 6574 years, and 75 years and over. See Appendix
II, Age adjustment.
3
Includes all other races not shown separately and unknown disability status for all data years, and unknown poverty level in 1989.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 11%
of persons aged 18 and over in 1989. Missing family income data were imputed for 1991 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
7
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Interpretation of vaccination data needs to take into account when universal recommendations were issued. Medicare payment for the costs of the vaccine
and its administration began in 1993. In 2000, CDC's Advisory Committee on Immunization Practices (ACIP) recommended universal influenza vaccination, with
rare exceptions, for persons aged 50 and over. See, Health, United States, 2014, Table 74 for historical data for adults age 50 and over. In 2010, ACIP recommended
universal influenza vaccination, with rare exceptions, for persons aged 6 months and over. For current ACIP vaccination recommendations, see:
http://www.cdc.gov/flu/professionals/acip/index.htm. Standard errors for selected years are available in the spreadsheet version of this table. Available from
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: immunization (1989) and the year 2000 objectives (1995).
Starting in 1997, data are from the sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1989 1995 2000 2005 2010 2012 2013 2014 2015
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 34.6 52.1 53.4 57.6 55.8 57.1 58.4 62.9
Female. . . . . . . . . . . . . . . . . . . . . . . . 14.3 33.6 53.9 58.4 61.3 63.1 61.8 63.7 64.2
Race 5
White only . . . . . . . . . . . . . . . . . . . . . . 14.8 35.3 55.6 58.4 61.6 62.3 61.7 63.1 65.8
Black or African American only . . . . . . . . . . . 6.4 21.9 30.6 40.2 45.5 46.0 48.4 49.2 49.9
American Indian or Alaska Native only . . . . . . . 31.2 * 70.1 * *48.5 *36.3 52.9 57.1 60.3
Asian only . . . . . . . . . . . . . . . . . . . . . . * *23.4 40.9 35.0 47.9 41.1 45.0 47.7 49.3
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . . --- --- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . . --- --- 55.6 64.8 65.5 45.4 50.8 71.2 60.4
Hispanic origin and race 5
Hispanic or Latino . . . . . . . . . . . . . . . . . . 9.8 23.2 30.4 27.5 39.0 43.4 39.2 45.2 41.7
Mexican . . . . . . . . . . . . . . . . . . . . . . 12.9 *18.8 32.0 31.3 41.4 45.5 47.4 47.8 49.1
Not Hispanic or Latino. . . . . . . . . . . . . . . . 14.3 34.5 54.4 58.1 61.3 61.2 61.4 62.7 65.5
White only. . . . . . . . . . . . . . . . . . . . . 15.0 35.9 56.8 60.6 63.5 64.0 63.6 64.7 68.1
Black or African American only . . . . . . . . . . 6.2 21.8 30.6 40.4 46.2 46.1 48.7 49.8 50.2
Percent of poverty level 6
Below 100% . . . . . . . . . . . . . . . . . . . . . 11.2 28.7 40.6 46.7 42.6 39.5 50.5 47.3 48.7
100%199%. . . . . . . . . . . . . . . . . . . . . 15.1 30.7 51.4 54.5 57.2 59.8 58.0 59.5 61.7
200%399%. . . . . . . . . . . . . . . . . . . . . 15.1 36.1 55.8 60.8 62.2 63.6 61.7 64.5 64.8
400% or more . . . . . . . . . . . . . . . . . . . . 15.5 39.5 56.9 55.3 64.0 61.4 61.6 63.2 67.1
Hispanic origin and race and
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . * *14.1 23.8 20.9 30.2 30.9 35.3 34.1 31.0
100%199% . . . . . . . . . . . . . . . . . . . *11.0 *15.6 32.3 26.9 36.9 42.0 39.1 44.4 45.2
200%399% . . . . . . . . . . . . . . . . . . . *11.1 *34.4 37.6 35.2 45.8 54.5 36.1 52.1 43.9
400% or more . . . . . . . . . . . . . . . . . . * *55.1 *26.4 *25.2 43.0 46.4 49.1 54.0 44.3
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . 13.3 32.5 47.9 55.6 51.1 46.5 59.1 55.4 54.1
100%199% . . . . . . . . . . . . . . . . . . 16.0 33.5 56.1 60.5 61.3 66.1 63.3 64.1 67.4
200%399% . . . . . . . . . . . . . . . . . . 15.7 37.1 57.6 64.1 64.9 65.9 65.2 66.9 68.4
400% or more . . . . . . . . . . . . . . . . . 15.9 39.3 59.5 57.4 66.0 63.5 63.2 64.5 70.2
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . *5.0 *22.6 28.8 42.3 34.9 36.1 48.9 46.0 53.3
100%199% . . . . . . . . . . . . . . . . . . 7.8 *20.9 28.1 36.6 46.4 44.5 46.9 49.1 46.9
200%399% . . . . . . . . . . . . . . . . . . *5.9 *21.7 35.5 41.6 51.8 54.1 49.4 47.9 44.1
400% or more . . . . . . . . . . . . . . . . . * * *32.6 44.6 50.1 45.4 50.3 56.0 61.8
See footnotes at end of table.
Characteristic 1989 1995 2000 2005 2010 2012 2013 2014 2015
asthma or cigarette smoking, to be consistent with the revised ACIP recommendation. Starting with data year 2012, the survey questionnaire changed and now asks
respondents if a health professional had ever told them they had chronic obstructive pulmonary disease (COPD), and this information was added to the list of lung
diseases used to construct the high-risk category. For more information on high-risk groups, see the 2009 ACIP recommendation. Available from:
http://www.cdc.gov/mmwr/pdf/wk/mm5934.pdf.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
6
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 11%
of persons aged 18 and over in 1989. Missing family income data were imputed for 1991 and beyond. See Appendix II, Family income; Poverty; Table VI.
7
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: A pneumococcal polysaccharide vaccine was first licensed in 1977. Medicare payment for the costs of the vaccine and its administration began in 1981. In
1997, CDC's Advisory Committee on Immunization Practices (ACIP) recommended universal pneumonia vaccination for adults aged 65 and over. CDC. Prevention of
pneumococcal disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997;46(RR-08);1-24. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/00047135.htm. For more information on the adult vaccination schedule, see:
http://www.cdc.gov/vaccines/schedules/index.html. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm. Some estimates have been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: immunization (1989) and the year 2000 objectives (1995).
Starting in 1997, data are from the sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1987 1993 1994 2000 2005 2008 2010 2013 2015
Characteristic 1987 1993 1994 2000 2005 2008 2010 2013 2015
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Questions concerning use of mammography differed slightly on the National Health Interview Survey across survey years. See Appendix II, Mammography. Data prior
to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS).
2
Includes all other races not shown separately, unknown poverty level in 1987, unknown health insurance status, unknown education level, and unknown disability status.
3
Estimates for women aged 40 and over are age-adjusted to the year 2000 standard population using four age groups: 4049 years, 5064 years, 6574 years, and 75
years and over. Estimates for women 50 years of age and over are age-adjusted using three age groups. See Appendix II, Age adjustment.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 11%
of women aged 40 and over in 1987. Missing family income data were imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with
1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children's Health Insurance Program
(CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military plans, other government-sponsored health
plans, and Medicare, not shown separately. Persons not covered by private insurance, Medicaid, CHIP, public assistance (through 1996), state-sponsored or other
government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian
Health Service coverage are considered to have no health insurance coverage. See Appendix II, Health insurance coverage.
7
Education categories shown are for 1998 and subsequent years. GED is General Educational Development high school equivalency diploma. In years prior to 1998, the
following categories based on number of years of school completed were used: less than 12 years, 12 years, 13 years or more. See Appendix II, Education.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with 2007 data and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
NOTES: See Appendix II, Mammography, for a discussion of the U.S. Preventive Services Task Force recommendations for mammography screening. Standard errors
are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data starting in 1997 are not strictly comparable with data for
earlier years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS). Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following supplements: cancer control (1987), health promotion and disease prevention (1990
1991), year 2000 objectives (19931994), and prevention (1998). Starting from 1999, data are from either the cancer control module or the cancer screening supplement
of the sample adult questionnaire, in addition to the family core questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1987 1993 1999 2000 2005 2008 2010 2013 2015
Characteristic 1987 1993 1999 2000 2005 2008 2010 2013 2015
Health insurance status
at the time of interview 6 Percent of women having a Pap smear within the past 3 years 1
1864 years, crude:
Insured . . . . . . . . . . . . . . . . . . . -- 84.7 87.2 87.8 85.6 83.4 82.8 80.0 78.2
Private . . . . . . . . . . . . . . . . . . -- 84.8 87.5 88.0 86.5 84.2 84.2 81.3 79.6
Medicaid . . . . . . . . . . . . . . . . . -- 82.7 84.2 85.8 80.9 80.3 78.0 75.7 72.6
Uninsured . . . . . . . . . . . . . . . . . . -- 69.4 73.3 70.4 67.7 67.1 61.9 57.6 57.3
Health insurance status
prior to interview 6
1864 years, crude:
Insured continuously all 12 months. . . . . -- 84.8 87.3 88.0 85.8 83.7 83.2 80.4 78.5
Uninsured for any period up to 12 months . -- 81.8 83.5 83.7 81.3 78.9 78.3 72.3 72.0
Uninsured more than 12 months . . . . . . -- 65.1 68.8 65.1 62.0 62.1 55.2 52.7 51.0
Age and education 7
25 years and over, crude:
No high school diploma or GED . . . . . . 57.1 61.9 66.1 69.9 64.1 60.6 56.7 56.2 55.9
High school diploma or GED . . . . . . . . 76.4 78.2 79.3 79.8 73.8 69.5 66.8 62.0 62.0
Some college or more . . . . . . . . . . . 84.0 84.4 87.8 88.0 84.6 82.6 80.7 77.1 76.9
2544 years:
No high school diploma or GED . . . . . 75.1 73.6 79.0 79.6 75.5 76.2 69.1 71.7 73.3
High school diploma or GED. . . . . . . 85.6 85.4 87.6 86.2 83.1 80.0 79.0 79.5 75.1
Some college or more . . . . . . . . . . 90.1 89.8 93.0 91.4 90.5 89.3 89.0 86.1 87.2
4564 years:
No high school diploma or GED . . . . . 58.0 65.6 71.6 75.7 69.7 70.4 63.4 63.0 60.3
High school diploma or GED. . . . . . . 72.3 77.6 79.8 81.8 79.0 73.9 72.4 67.0 70.7
Some college or more . . . . . . . . . . 80.1 83.0 85.7 89.1 84.1 83.0 81.5 78.7 79.9
65 years and over:
No high school diploma or GED . . . . . 44.0 50.7 51.8 56.6 46.0 36.7 37.7 33.8 32.9
High school diploma or GED. . . . . . . 55.4 61.6 63.7 66.9 52.5 49.3 42.6 38.8 39.0
Some college or more . . . . . . . . . . 59.4 62.3 68.8 69.8 63.8 59.0 54.9 49.7 47.5
Disability measure 8
18 years and over, crude:
Any basic actions difficulty or complex
activity limitation. . . . . . . . . . . . . . -- -- 74.4 75.4 69.1 66.1 63.8 59.3 59.9
Any basic actions difficulty. . . . . . . . -- -- 74.3 75.1 69.1 66.2 63.6 59.2 59.9
Any complex activity limitation. . . . . . -- -- 69.3 71.0 62.2 60.1 58.5 52.8 54.6
No disability. . . . . . . . . . . . . . . . . -- -- 83.8 84.1 82.6 80.4 78.9 75.2 74.5
See footnotes at end of table.
Characteristic 1987 1993 1999 2000 2005 2008 2010 2013 2015
Characteristic 1987 1993 1999 2000 2005 2008 2010 2013 2015
Health insurance status Percent of women having a Pap smear within the past 3 years,
at the time of interview 6 among those who have not had a hysterectomy 9
1864 years, crude:
Insured . . . . . . . . . . . . . . . . . . . -- 85.9 87.8 88.7 87.1 85.8 85.1 82.3 80.5
Private . . . . . . . . . . . . . . . . . . -- 86.0 88.1 88.8 87.9 86.6 86.2 83.5 81.8
Medicaid . . . . . . . . . . . . . . . . . -- 83.9 84.2 86.9 82.6 82.4 79.7 77.6 74.8
Uninsured . . . . . . . . . . . . . . . . . . -- 70.2 74.3 70.8 68.0 67.9 63.1 59.6 59.3
Health insurance status
prior to interview 6
1864 years, crude:
Insured continuously all 12 months. . . . . -- 86.1 88.0 88.9 87.2 86.1 85.4 82.9 80.9
Uninsured for any period up to 12 months . -- 81.7 84.4 84.4 82.7 80.9 79.7 74.5 73.9
Uninsured more than 12 months . . . . . . -- 66.5 69.9 65.5 62.7 62.4 56.6 54.6 52.8
Age and education 7
25 years and over, crude:
No high school diploma or GED . . . . . . 61.7 63.2 68.3 72.5 66.9 67.5 61.0 60.2 61.7
High school diploma or GED . . . . . . . . 80.0 80.2 81.2 82.7 77.1 73.6 71.5 68.3 67.9
Some college or more . . . . . . . . . . . 86.7 86.7 89.9 90.1 88.2 86.8 85.3 82.3 82.9
2544 years:
No high school diploma or GED . . . . . 77.3 73.1 78.4 78.6 74.7 76.5 69.0 71.6 73.8
High school diploma or GED. . . . . . . 87.6 85.6 87.4 86.2 83.4 79.5 78.8 79.6 75.5
Some college or more . . . . . . . . . . 91.5 90.0 92.9 91.7 91.1 89.7 89.2 86.5 87.8
4564 years:
No high school diploma or GED . . . . . 63.9 65.5 73.2 77.5 70.5 74.8 66.8 65.7 65.3
High school diploma or GED. . . . . . . 77.0 78.8 81.6 84.1 80.1 77.9 75.8 71.4 76.1
Some college or more . . . . . . . . . . 85.5 86.2 87.7 91.0 87.9 87.9 86.4 84.5 85.4
65 years and over:
No high school diploma or GED . . . . . 48.4 51.3 52.7 59.7 49.2 43.0 40.6 34.5 36.9
High school diploma or GED. . . . . . . 60.4 63.8 65.0 71.3 56.5 53.6 48.7 45.3 43.4
Some college or more . . . . . . . . . . 63.6 65.7 75.6 74.9 69.9 66.1 64.0 57.6 58.2
Disability measure 8
18 years and over, crude:
Any basic actions difficulty or complex
activity limitation. . . . . . . . . . . . . . -- -- 77.8 78.6 73.7 73.4 70.6 66.1 67.1
Any basic actions difficulty. . . . . . . . -- -- 77.8 78.5 73.9 73.8 70.6 66.2 67.4
Any complex activity limitation. . . . . . -- -- 73.9 73.9 67.4 68.1 65.9 59.1 61.4
No disability. . . . . . . . . . . . . . . . . -- -- 84.5 85.1 84.0 82.1 80.8 77.4 77.2
See footnotes at end of table.
NOTES: Currently, the U.S. Preventive Services Task Force (USPSTF) recommends Pap smears every three years for women aged 21 to 65, although the USPSTF
recommendations have changed over time. See Appendix II, Pap smear. Standard errors are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from the following supplements: cancer control (1987), year 2000 objectives (19931994), and prevention
(1998). Starting in 1999, data are either from the cancer control module or the cancer screening supplement of the sample adult questionnaire, in addition to the family
core questionnaire. See Appendix I, National Health Interview Survey (NHIS).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Includes reports of home fecal occult blood test (FOBT) in the past year, sigmoidoscopy procedure in the past 5 years with FOBT in the past 3 years, or colonoscopy in
the past 10 years. Colorectal procedures are performed for diagnostic and screening purposes.
2
Questions differed slightly on the National Health Interview Survey across survey years. See Appendix II, Colorectal tests or procedures.
3
Includes any colonoscopy in the past 10 years, alone or in addition to another type of colorectal test or procedure.
4
Includes all other races not shown separately, unknown disability status, and unknown education level.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. The five single-race and multiple-race categories shown in the table conform to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity. Starting with 2003 data, race responses of other race and unspecified multiple race were
treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
6
Based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed. See Appendix II,
Family income; Poverty; Table VI.
7
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended screening for colorectal cancer annually using FOBT, every 5 years using
sigmoidoscopy with FOBT every 3 years, or every 10 years using colonoscopy in adults, beginning at age 50 and continuing until age 75. The USPSTF
recommendations were updated in 2016 to include additional screening methods but did not emphasize one method over another, as the risk and benefits vary from
method to method. For more information, see: http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer
screening2. Colonoscopy estimates are shown separately in the table because of the recent large increase in its utilization. The 2009 Colorectal Cancer Screening
Guidelines from the American College of Gastroenterology recommended that African American persons start routine testing for colorectal cancer at age 45. See: http://
www.acg.gi.org/patients/ccrk/ for more information. Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.
cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey. Data are from either the cancer control module or the cancer screening supplement of the sample adult
questionnaire, in addition to the family core questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015
Hispanic or Latino:
Percent of poverty level:
Below 100% . . . . . . . . . . . . . . . . 21.9 27.0 21.7 25.0 32.0 27.9 19.6 23.4 18.2
100%199% . . . . . . . . . . . . . . . . 20.8 23.3 18.1 28.8 31.6 24.9 15.6 18.0 15.3
200%399% . . . . . . . . . . . . . . . . 21.4 19.5 17.0 24.6 25.2 28.2 19.6 16.1 11.0
400% or more . . . . . . . . . . . . . . . 17.7 21.4 16.0 *20.2 28.6 *18.0 16.4 18.0 14.9
Not Hispanic or Latino:
White only:
Percent of poverty level:
Below 100%. . . . . . . . . . . . . . . 25.5 33.7 24.7 27.2 37.4 26.8 24.4 31.6 23.6
100%199% . . . . . . . . . . . . . . 22.3 26.3 17.8 25.8 29.2 21.5 20.7 24.7 15.9
200%399% . . . . . . . . . . . . . . 17.8 17.6 13.9 20.9 21.2 18.3 16.3 15.9 11.8
400% or more . . . . . . . . . . . . . . 16.5 15.5 12.7 19.0 21.0 15.0 15.4 13.2 11.7
Black or African American only:
Percent of poverty level:
Below 100%. . . . . . . . . . . . . . . 29.3 32.4 23.7 39.5 41.6 30.8 23.0 26.6 20.1
100%199% . . . . . . . . . . . . . . 22.5 27.5 23.5 31.7 34.5 29.3 18.5 23.7 20.6
200%399% . . . . . . . . . . . . . . 18.5 22.3 17.4 23.9 24.6 *27.1 16.3 21.4 13.8
400% or more . . . . . . . . . . . . . . 16.1 18.9 16.3 *18.8 *24.1 * 15.2 16.1 *18.0
Health insurance status
Insured. . . . . . . . . . . . . . . . . . . . . . 19.8 22.3 16.9 24.4 28.1 21.7 17.5 19.2 14.6
Private . . . . . . . . . . . . . . . . . . . . 17.5 17.1 12.5 20.9 21.8 16.7 15.9 14.9 10.6
Medicaid . . . . . . . . . . . . . . . . . . . 28.2 30.0 22.8 33.0 35.5 27.3 24.1 26.4 20.4
Uninsured . . . . . . . . . . . . . . . . . . . . 20.2 19.4 14.3 23.0 24.0 *19.4 18.9 17.6 12.7
Health insurance status
prior to interview 5
Insured continuously all 12 months . . . . . . . 19.6 22.2 16.8 24.1 28.1 21.4 17.3 19.1 14.6
Uninsured for any period up to 12 months . . . 24.0 23.7 20.7 27.1 28.0 29.2 21.9 21.3 16.6
Uninsured more than 12 months . . . . . . . . 18.4 17.6 *10.4 19.3 *21.3 * 18.1 16.7 *9.8
See footnotes at end of table.
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015
Percent of poverty level and health Percent of children with one or more emergency department visits 1
insurance status prior to interview 4,5
Below 100%:
Insured continuously all 12 months. . . . . . 26.3 31.7 23.6 30.9 36.3 29.6 22.8 28.7 20.1
Uninsured for any period up to 12 months . . 26.5 30.3 23.8 29.7 34.7 * 24.4 27.5 *24.7
Uninsured more than 12 months . . . . . . . 17.5 *19.6 * *16.0 * * 18.0 *16.0 *
100%199%:
Insured continuously all 12 months. . . . . . 21.8 26.2 18.5 28.0 32.4 23.4 18.6 22.4 16.1
Uninsured for any period up to 12 months . . 24.5 28.4 23.2 29.7 30.9 *34.5 21.0 27.0 *17.8
Uninsured more than 12 months . . . . . . . 19.5 17.6 * *22.5 * * 18.6 *17.2 *
200%399%:
Insured continuously all 12 months. . . . . . 17.7 18.4 14.7 21.2 22.8 20.1 16.1 16.3 12.1
Uninsured for any period up to 12 months . . 21.1 16.2 15.5 *19.5 *22.7 *25.9 22.1 *12.6 *10.6
Uninsured more than 12 months . . . . . . . 19.2 *17.4 * *22.7 * * 17.6 *18.7 *
400% or more:
Insured continuously all 12 months. . . . . . 16.2 16.1 12.8 18.9 22.0 14.3 15.1 13.5 12.0
Uninsured for any period up to 12 months . . *19.2 * * * * * * * *
Uninsured more than 12 months . . . . . . . * * * * * * * * *
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . 18.5 22.3 16.5 20.7 27.8 22.4 17.4 19.6 13.7
Midwest . . . . . . . . . . . . . . . . . . . . . 19.5 23.3 19.1 26.0 28.8 23.5 16.4 20.7 17.1
South . . . . . . . . . . . . . . . . . . . . . . 21.8 23.4 17.6 25.6 30.4 23.5 19.9 19.5 14.9
West . . . . . . . . . . . . . . . . . . . . . . . 18.5 19.1 13.7 23.5 23.3 17.2 15.9 16.8 11.9
Location of residence 6
Within MSA . . . . . . . . . . . . . . . . . . . 19.7 21.8 16.4 23.9 27.7 21.1 17.4 18.6 14.0
Outside MSA . . . . . . . . . . . . . . . . . . 20.8 24.2 20.0 26.2 28.6 25.6 18.6 22.1 17.3
Percent of children with two or more emergency department visits 1
All children . . . . . . . . . . . . . . . . . . .
2
7.1 8.4 5.3 9.6 10.8 7.0 5.8 7.2 4.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 7.3 8.5 5.4 9.9 11.3 7.4 6.0 7.0 4.4
Female. . . . . . . . . . . . . . . . . . . . . . 6.9 8.3 5.3 9.4 10.3 6.5 5.7 7.3 4.7
Race 3
White only . . . . . . . . . . . . . . . . . . . . 6.6 7.6 4.9 8.4 10.1 6.0 5.7 6.3 4.3
Black or African American only . . . . . . . . . 9.6 12.6 7.6 14.9 15.7 10.0 6.9 11.0 6.3
American Indian or Alaska Native only . . . . . * * *13.5 * * * * * *
Asian only . . . . . . . . . . . . . . . . . . . . *5.7 7.3 *2.6 *12.9 * * * *7.1 *
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . --- * * --- * * --- * *
2 or more races . . . . . . . . . . . . . . . . . --- 10.3 6.7 --- *11.7 *10.2 --- *9.2 *
Hispanic origin and race 3
Hispanic or Latino . . . . . . . . . . . . . . . . 8.9 8.6 6.2 11.8 11.7 8.6 7.0 6.6 5.0
Not Hispanic or Latino. . . . . . . . . . . . . . 6.8 8.4 5.0 9.2 10.5 6.4 5.7 7.3 4.3
White only. . . . . . . . . . . . . . . . . . . 6.2 7.4 4.4 7.8 9.3 5.1 5.5 6.4 4.1
Black or African American only . . . . . . . . 9.3 12.3 7.4 14.6 15.8 9.8 6.8 10.4 6.2
Percent of poverty level 4
Below 100% . . . . . . . . . . . . . . . . . . . 11.1 13.4 8.9 14.5 15.3 11.8 8.9 12.1 7.4
100%199%. . . . . . . . . . . . . . . . . . . 8.3 10.3 7.2 12.2 13.4 9.7 6.3 8.4 6.0
200%399%. . . . . . . . . . . . . . . . . . . 6.2 6.3 3.4 7.4 7.3 4.1 5.6 5.9 3.0
400% or more . . . . . . . . . . . . . . . . . . 4.0 5.0 3.0 5.0 7.3 *3.5 3.6 3.9 2.7
See footnotes at end of table.
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015
Hispanic origin and race and
percent of poverty level 3,4 Percent of children with two or more emergency department visits 1
Hispanic or Latino:
Percent of poverty level:
Below 100% . . . . . . . . . . . . . . . . 10.4 9.9 7.0 13.9 10.9 *9.1 8.0 9.2 5.9
100%199% . . . . . . . . . . . . . . . . 8.2 9.4 7.3 12.0 15.4 11.7 5.7 5.5 5.5
200%399% . . . . . . . . . . . . . . . . 8.5 5.9 *4.0 10.0 *8.0 *5.7 *7.6 *4.6 *3.1
400% or more . . . . . . . . . . . . . . . *5.0 *6.5 *5.6 * * * * *5.2 *
Not Hispanic or Latino:
White only:
Percent of poverty level:
Below 100%. . . . . . . . . . . . . . . 10.7 14.0 9.6 12.2 15.5 *10.1 9.8 13.1 *9.4
100%199% . . . . . . . . . . . . . . 8.0 10.4 7.7 11.2 12.3 *8.6 6.4 9.4 7.3
200%399% . . . . . . . . . . . . . . 6.0 5.7 2.9 6.7 *6.5 *2.8 5.6 5.4 *3.0
400% or more . . . . . . . . . . . . . . 3.7 5.0 2.6 4.6 7.6 *3.5 3.3 3.9 *2.2
Black or African American only:
Percent of poverty level:
Below 100%. . . . . . . . . . . . . . . 12.7 16.1 9.9 19.1 22.1 14.5 8.8 12.4 *7.5
100%199% . . . . . . . . . . . . . . 9.2 12.4 6.9 *13.5 *14.6 * *7.2 11.1 *6.5
200%399% . . . . . . . . . . . . . . 5.8 9.9 *5.6 *8.9 *10.2 * *4.5 *9.8 *
400% or more . . . . . . . . . . . . . . * *3.7 * * * * * * *
Health insurance status
Insured. . . . . . . . . . . . . . . . . . . . . . 7.0 8.5 5.4 9.6 11.0 7.1 5.7 7.1 4.6
Private . . . . . . . . . . . . . . . . . . . . 5.2 5.5 3.0 6.8 7.4 3.5 4.5 4.6 2.8
Medicaid . . . . . . . . . . . . . . . . . . . 13.1 12.8 8.8 16.2 15.3 11.5 10.4 11.2 7.4
Uninsured . . . . . . . . . . . . . . . . . . . . 7.7 8.0 *3.5 9.8 *8.5 * 6.8 7.8 *3.5
Health insurance status
prior to interview 5
Insured continuously all 12 months . . . . . . . 6.9 8.4 5.3 9.4 10.8 6.9 5.7 7.1 4.5
Uninsured for any period up to 12 months . . . 8.5 10.1 7.8 11.5 13.3 *10.1 6.6 8.4 *6.7
Uninsured more than 12 months . . . . . . . . 6.8 7.8 * *8.6 * * 6.2 *7.9 *
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . 6.2 7.8 4.6 7.6 10.3 7.5 5.4 6.6 3.2
Midwest . . . . . . . . . . . . . . . . . . . . . 6.6 9.1 5.7 10.4 11.4 6.5 4.8 8.0 5.3
South . . . . . . . . . . . . . . . . . . . . . . 8.0 9.1 5.9 10.1 12.9 7.6 6.9 7.1 5.1
West . . . . . . . . . . . . . . . . . . . . . . . 7.1 7.2 4.5 10.0 7.6 6.2 5.6 7.0 3.6
Location of residence 6
Within MSA . . . . . . . . . . . . . . . . . . . 7.2 8.3 5.0 9.6 10.6 6.6 5.9 7.0 4.2
Outside MSA . . . . . . . . . . . . . . . . . . 6.8 9.3 7.2 9.7 12.2 9.5 5.6 7.9 6.2
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
See Appendix II, Emergency department or emergency room visit.
2
Includes all other races not shown separately and unknown health insurance status.
3
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
4
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
5
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with
1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children's Health Insurance Program
(CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other government, and Medicare coverage.
Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans
are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See
Appendix II, Health insurance coverage.
6
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
18 years and over, age-adjusted 2,3 . . . . . . . . . . . 19.6 20.2 21.4 18.8 6.7 6.9 7.8 6.9
18 years and over, crude 2 . . . . . . . . . . . . . . . . 19.6 20.1 21.3 18.8 6.7 6.8 7.7 6.9
Age
1844 years . . . . . . . . . . . . . . . . . . . . . . . 20.7 20.5 22.0 18.6 6.8 7.0 8.4 6.9
1824 years . . . . . . . . . . . . . . . . . . . . . . 26.3 25.7 25.4 20.5 9.1 8.8 9.6 7.5
2544 years . . . . . . . . . . . . . . . . . . . . . . 19.0 18.8 20.7 17.9 6.2 6.4 8.0 6.7
4564 years . . . . . . . . . . . . . . . . . . . . . . . 16.2 17.6 19.2 17.4 5.6 5.6 6.7 6.1
4554 years . . . . . . . . . . . . . . . . . . . . . . 15.7 17.9 18.6 16.4 5.5 5.8 6.6 6.0
5564 years . . . . . . . . . . . . . . . . . . . . . . 16.9 17.0 19.8 18.4 5.7 5.3 6.8 6.2
65 years and over . . . . . . . . . . . . . . . . . . . . 22.0 23.7 23.7 21.8 8.1 8.6 7.7 8.2
6574 years . . . . . . . . . . . . . . . . . . . . . . 20.3 21.6 20.7 18.3 7.1 7.4 6.4 6.9
75 years and over. . . . . . . . . . . . . . . . . . . 24.3 26.2 27.4 26.7 9.3 10.0 9.4 10.0
Sex 3
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 18.7 18.5 16.9 5.9 5.7 6.0 5.7
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 20.2 21.6 24.3 20.6 7.5 7.9 9.6 8.1
Race 3,4
White only . . . . . . . . . . . . . . . . . . . . . . . . 19.0 19.4 20.7 18.0 6.2 6.4 7.2 6.4
Black or African American only . . . . . . . . . . . . . 25.9 26.5 28.6 26.6 11.1 10.8 12.6 10.9
American Indian or Alaska Native only . . . . . . . . . 24.8 30.3 22.6 28.3 13.1 *12.6 *11.8 16.1
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 11.6 13.6 13.3 9.4 *2.9 *3.8 3.3 2.7
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . . . . -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . . . . . -- 32.5 29.7 27.1 -- 11.3 11.1 12.4
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . . . . -- 33.9 31.1 29.0 -- *9.4 *15.2 *14.1
Hispanic origin and race 3,4
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . 19.2 18.3 19.8 17.3 7.4 7.0 6.9 6.4
Mexican . . . . . . . . . . . . . . . . . . . . . . . . 17.8 17.4 18.1 16.0 6.4 7.1 6.1 6.0
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 19.7 20.6 21.9 19.2 6.7 6.9 8.1 7.0
White only. . . . . . . . . . . . . . . . . . . . . . . 19.1 19.8 21.1 18.3 6.2 6.4 7.4 6.4
Black or African American only . . . . . . . . . . . . 25.9 26.5 29.0 26.5 11.0 10.8 12.7 10.8
Percent of poverty level 3,5
Below 100% . . . . . . . . . . . . . . . . . . . . . . . 28.1 29.0 30.6 29.5 12.8 13.3 14.9 14.7
100%199%. . . . . . . . . . . . . . . . . . . . . . . 23.8 23.9 25.6 24.1 9.3 9.6 10.5 9.9
200%399%. . . . . . . . . . . . . . . . . . . . . . . 18.3 19.8 20.4 17.1 5.9 6.3 6.8 6.2
400% or more . . . . . . . . . . . . . . . . . . . . . . 15.9 16.8 17.0 14.3 3.9 4.5 4.7 3.6
Hispanic origin and race and
percent of poverty level 3,4,5
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . . . 22.1 22.4 23.6 22.6 9.8 9.7 11.5 11.5
100%199% . . . . . . . . . . . . . . . . . . . . . 19.2 18.1 19.9 17.7 8.1 6.7 6.3 6.7
200%399% . . . . . . . . . . . . . . . . . . . . . 18.5 17.3 18.1 13.3 6.0 7.4 5.2 4.1
400% or more . . . . . . . . . . . . . . . . . . . . 14.6 16.4 18.8 17.5 *3.8 *4.3 *5.5 *4.4
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . . . 29.5 30.1 33.3 32.0 13.0 13.9 15.5 16.0
100%199% . . . . . . . . . . . . . . . . . . . . 24.3 25.5 26.8 26.0 9.1 10.4 11.2 10.5
200%399% . . . . . . . . . . . . . . . . . . . . 18.1 20.1 20.3 17.4 5.8 6.3 6.5 6.4
400% or more . . . . . . . . . . . . . . . . . . . 15.8 16.3 16.9 14.0 3.8 4.1 4.9 3.5
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . . . 34.6 35.4 36.9 35.8 17.5 17.4 20.2 17.1
100%199% . . . . . . . . . . . . . . . . . . . . 29.2 28.5 33.5 32.6 12.8 12.2 15.9 14.0
200%399% . . . . . . . . . . . . . . . . . . . . 20.8 23.2 25.7 22.2 8.1 8.0 10.2 8.3
400% or more . . . . . . . . . . . . . . . . . . . 18.2 22.6 18.8 18.3 5.9 8.8 *4.0 5.4
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
See Appendix II, Emergency department or emergency room visit.
2
Includes all other races not shown separately, unknown health insurance status, and unknown disability status.
3
Estimates are for persons aged 18 and over and are age-adjusted to the year 2000 standard population using five age groups: 1844 years, 4554 years, 5564 years,
6574 years, and 75 years and over. See Appendix II, Age adjustment.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Estimates for persons aged 1864 are age-adjusted to the year 2000 standard population using three age groups: 1844 years, 4554 years, and 5564 years. See
Appendix II, Age adjustment.
7
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with
1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children's Health Insurance Program
(CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military plans, other government-sponsored health
plans, and Medicare, not shown separately. Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans
(starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are considered to
have no health insurance coverage. See Appendix II, Health insurance coverage.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
All ages, age-adjusted 2,3 . . . . . . . . . . . . 31,706 33,007 30,402 1,076.4 1,084.0 983.4
All ages, crude 2 . . . . . . . . . . . . . . . . . 31,706 33,007 30,402 1,068.6 1,067.9 968.9
Unintentional injuries 4 . . . . . . . . . . . . 25,658 27,275 25,078 864.7 882.4 799.2
Falls . . . . . . . . . . . . . . . . . . . . 8,100 9,932 8,760 273.0 321.3 279.2
Struck by or against objects or persons . . 2,935 3,166 3,149 98.9 102.4 100.4
Motor vehicle traffic . . . . . . . . . . . . 3,714 3,557 3,207 125.2 115.1 102.2
Cut or pierce . . . . . . . . . . . . . . . . 2,145 1,922 1,699 72.3 62.2 54.1
Intentional injuries . . . . . . . . . . . . . . 1,977 2,446 1,692 66.6 79.1 53.9
Male
All ages, age-adjusted 2,3 . . . . . . . . . . . . 16,966 17,483 15,184 1,166.1 1,164.5 1,000.4
All ages, crude 2 . . . . . . . . . . . . . . . . . 16,966 17,483 15,184 1,164.2 1,150.5 985.9
Unintentional injuries 4 . . . . . . . . . . . . 13,736 14,451 12,447 942.5 951.0 808.1
Falls . . . . . . . . . . . . . . . . . . . . 3,685 4,689 3,649 252.9 308.6 236.9
Struck by or against objects or persons . . 1,833 2,008 1,781 125.8 132.2 115.6
Motor vehicle traffic . . . . . . . . . . . . 1,733 1,710 1,519 118.9 112.5 98.6
Cut or pierce . . . . . . . . . . . . . . . . 1,392 1,236 1,042 95.5 81.4 67.7
Intentional injuries . . . . . . . . . . . . . . 1,135 1,396 907 77.8 91.8 58.9
Under 18 years 2 . . . . . . . . . . . . . . . . . 5,072 5,309 4,117 1,346.6 1,397.8 1,093.6
Unintentional injuries 4 . . . . . . . . . . . . 4,391 4,724 3,641 1,165.8 1,243.9 967.0
Falls . . . . . . . . . . . . . . . . . . . . 1,362 1,737 1,092 361.5 457.4 290.1
Struck by or against objects or persons . . 816 997 735 216.6 262.6 195.2
Motor vehicle traffic . . . . . . . . . . . . 357 301 198 94.8 79.1 52.6
Cut or pierce . . . . . . . . . . . . . . . . 291 238 265 77.3 62.7 70.5
Intentional injuries . . . . . . . . . . . . . . 190 167 *122 50.4 44.1 *32.5
1824 years 2 . . . . . . . . . . . . . . . . . . 2,552 2,511 2,122 1,729.5 1,612.1 1,348.5
Unintentional injuries 4 . . . . . . . . . . . . 1,985 1,890 1,634 1,345.4 1,213.7 1,038.4
Falls . . . . . . . . . . . . . . . . . . . . 318 390 268 215.2 250.4 170.3
Struck by or against objects or persons . . 290 259 227 196.9 166.6 144.0
Motor vehicle traffic . . . . . . . . . . . . 386 357 343 261.6 229.3 217.9
Cut or pierce . . . . . . . . . . . . . . . . 265 192 152 179.5 123.5 96.8
Intentional injuries . . . . . . . . . . . . . . 273 403 216 185.2 258.7 137.3
2544 years 2 . . . . . . . . . . . . . . . . . . 5,199 4,850 4,429 1,243.6 1,184.3 1,079.9
Unintentional injuries 4 . . . . . . . . . . . . 4,001 3,690 3,426 957.1 901.1 835.4
Falls . . . . . . . . . . . . . . . . . . . . 763 815 791 182.4 199.1 192.8
Struck by or against objects or persons . . 472 452 495 112.9 110.4 120.7
Motor vehicle traffic . . . . . . . . . . . . 629 591 509 150.5 144.3 124.1
Cut or pierce . . . . . . . . . . . . . . . . 480 423 354 114.8 103.2 86.4
Intentional injuries . . . . . . . . . . . . . . 436 589 424 104.4 143.8 103.4
4564 years 2 . . . . . . . . . . . . . . . . . . 2,842 3,270 3,101 790.0 822.7 767.3
Unintentional injuries 4 . . . . . . . . . . . . 2,275 2,741 2,505 632.5 689.6 620.0
Falls . . . . . . . . . . . . . . . . . . . . 599 909 716 166.6 228.6 177.2
Struck by or against objects or persons . . 208 204 256 57.9 51.4 63.4
Motor vehicle traffic . . . . . . . . . . . . 262 334 389 72.9 84.0 96.3
Cut or pierce . . . . . . . . . . . . . . . . 285 294 190 79.2 73.9 47.1
Intentional injuries . . . . . . . . . . . . . . 205 219 130 57.1 55.2 32.1
65 years and over 2 . . . . . . . . . . . . . . . 1,301 1,544 1,415 837.5 871.6 736.6
Unintentional injuries 4 . . . . . . . . . . . . 1,082 1,406 1,240 696.8 793.5 645.5
Falls . . . . . . . . . . . . . . . . . . . . 644 838 782 414.5 473.0 407.3
Struck by or against objects or persons . . 46 95 *67 29.8 53.6 *35.1
Motor vehicle traffic . . . . . . . . . . . . 98 128 *79 63.4 72.1 *41.4
Cut or pierce . . . . . . . . . . . . . . . . 70 90 *80 45.3 50.6 *41.7
Intentional injuries . . . . . . . . . . . . . . * * * * * *
See footnotes at end of table.
All ages, age-adjusted 2,3 . . . . . . . . . . . . 14,740 15,524 15,218 980.5 997.2 959.0
All ages, crude 2 . . . . . . . . . . . . . . . . . 14,740 15,524 15,218 976.3 988.0 952.6
Unintentional injuries 4 . . . . . . . . . . . . 11,922 12,824 12,632 789.7 816.1 790.7
Falls . . . . . . . . . . . . . . . . . . . . 4,415 5,243 5,111 292.4 333.6 319.9
Struck by or against objects or persons . . 1,102 1,158 1,368 73.0 73.7 85.7
Motor vehicle traffic . . . . . . . . . . . . 1,981 1,847 1,688 131.2 117.6 105.7
Cut or pierce . . . . . . . . . . . . . . . . 753 685 657 49.9 43.6 41.1
Intentional injuries . . . . . . . . . . . . . . 843 1,050 785 55.8 66.8 49.1
Under 18 years 2 . . . . . . . . . . . . . . . . . 3,625 3,673 3,602 1,008.7 1,013.2 1,000.4
Unintentional injuries 4 . . . . . . . . . . . . 3,058 3,120 3,105 851.1 860.7 862.2
Falls . . . . . . . . . . . . . . . . . . . . 1,039 1,138 1,047 289.1 314.0 290.9
Struck by or against objects or persons . . 419 425 522 116.7 117.2 145.0
Motor vehicle traffic . . . . . . . . . . . . 367 302 273 102.1 83.4 75.8
Cut or pierce . . . . . . . . . . . . . . . . 160 158 *148 44.4 43.7 *41.0
Intentional injuries . . . . . . . . . . . . . . 188 196 144 52.3 54.1 39.9
1824 years 2 . . . . . . . . . . . . . . . . . . 1,882 1,936 1,769 1,329.3 1,297.1 1,160.3
Unintentional injuries . . . . . . . . . . .
4
. 1,431 1,530 1,367 1,010.5 1,025.0 896.7
Falls . . . . . . . . . . . . . . . . . . . . 290 305 326 205.0 204.5 214.2
Struck by or against objects or persons . . 146 171 129 103.4 114.7 84.4
Motor vehicle traffic . . . . . . . . . . . . 397 460 372 280.6 308.1 244.3
Cut or pierce . . . . . . . . . . . . . . . . 116 *94 81 82.2 *63.3 53.2
Intentional injuries . . . . . . . . . . . . . . 176 251 151 124.2 168.4 99.2
2544 years 2 . . . . . . . . . . . . . . . . . . 4,173 4,233 3,914 1,004.2 1,034.6 947.8
Unintentional injuries 4 . . . . . . . . . . . . 3,266 3,308 3,105 785.8 808.5 751.8
Falls . . . . . . . . . . . . . . . . . . . . 873 941 921 210.1 229.9 223.0
Struck by or against objects or persons . . 309 284 326 74.3 69.4 79.0
Motor vehicle traffic . . . . . . . . . . . . 719 616 529 173.1 150.5 128.0
Cut or pierce . . . . . . . . . . . . . . . . 269 219 215 64.7 53.6 52.1
Intentional injuries . . . . . . . . . . . . . . 313 408 310 75.4 99.8 75.0
4564 years 2 . . . . . . . . . . . . . . . . . . 2,904 3,101 3,173 767.8 741.9 746.6
Unintentional injuries 4 . . . . . . . . . . . . 2,278 2,519 2,538 602.2 602.7 597.4
Falls . . . . . . . . . . . . . . . . . . . . 865 1,075 993 228.7 257.1 233.7
Struck by or against objects or persons . . 160 197 246 42.2 47.2 58.0
Motor vehicle traffic . . . . . . . . . . . . 359 345 388 94.8 82.6 91.2
Cut or pierce . . . . . . . . . . . . . . . . 158 157 159 41.7 37.6 37.4
Intentional injuries . . . . . . . . . . . . . . 149 182 *171 39.4 43.5 *40.2
65 years and over 2 . . . . . . . . . . . . . . . 2,155 2,582 2,760 1,002.9 1,110.7 1,116.8
Unintentional injuries 4 . . . . . . . . . . . . 1,889 2,348 2,517 879.1 1,009.8 1,018.2
Falls . . . . . . . . . . . . . . . . . . . . 1,347 1,784 1,823 626.9 767.2 737.7
Struck by or against objects or persons . . 69 81 *145 31.9 34.7 *58.6
Motor vehicle traffic . . . . . . . . . . . . 139 124 127 64.5 53.5 51.2
Cut or pierce . . . . . . . . . . . . . . . . *50 *56 *54 *23.3 *24.2 *21.8
Intentional injuries . . . . . . . . . . . . . . * * * * * *
*Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Intent and mechanism of injury are based on the first-listed external cause of injury code (E code). Intentional injuries include suicide attempts and assaults. See
Appendix II, External cause of injury; Injury; Injury-related visit; Table IX for a listing of E codes.
2
Includes all injury-related visits not shown separately in table, including those with undetermined intent (1% in 20122013) and insufficient or no information to code
cause of injury (11% in 20122013).
3
Rates are age-adjusted to the year 2000 standard population using six age groups: under 18 years, 1824 years, 2544 years, 4564 years, 6574 years, and 75 years
and over. See Appendix II, Age adjustment.
4
Includes unintentional injury-related visits with mechanism of injury not shown in table.
NOTES: An emergency department visit was considered injury-related if the first-listed diagnosis was injury-related (ICD9CM 800909.2, 909.4, 909.9994.9,
995.50995.59, and 995.80995.85) or the first-listed external cause code (E code) was injury-related (ICD9CM E800E869, E880E929, and E950E999). See: http://
www.cdc.gov/nchs/injury/injury_tools.htm for code used to classify injury-related visits in this table. Visits with a first-listed diagnosis or first-listed E code describing
a complication or adverse effect of medical care were not considered injury related. For more information on injury-related visits, see Bergen G, Chen LH, Warner M,
Fingerhut LA. Injury in the United States: 2007 Chartbook. Hyattsville, MD: NCHS. 2008. Available from: http://www.cdc.gov/nchs/data/misc/injury2007.pdf. Estimates
for first-listed injury-related visits were further limited to those visits that were initial visits for the injury. This was determined using an imputed variable in 20052006;
for 2007 and beyond this was determined by using the initial visit episode of care information collected on the questionnaire. Limiting the estimates to initial visits
decreases the total number of injury-related visits by 9% in 20052006, 14% in 20072008 (shown in spreadsheet version), 10%12% in 20082009, 20092010, and
20102011 (shown in spreadsheet version), 13% in 20112012, and 11% in 20122013. Rates were calculated using estimates of the civilian population of the United
States including institutionalized persons. Population data are from unpublished tabulations provided by the U.S. Census Bureau. Rates for 20052010 were calculated
using postcensal population estimates based on the 2000 census. Rates for 2011 and beyond were calculated using postcensal population estimates based on the
2010 census. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Hospital Ambulatory Medical Care Survey. See Appendix I, National Hospital Ambulatory Medical Care Survey (NHAMCS).
NOTES: Rates for 19952000 were computed using 1990-based postcensal estimates of the civilian noninstitutionalized population as of July 1, adjusted for net
underenumeration using the 1990 National Population Adjustment Matrix from the U.S. Census Bureau. For 20012010 data, rates were computed using 2000-based
postcensal estimates of the civilian noninstitutionalized population as of July 1. For 2011 data and beyond, rates were computed using 2010-based postcensal
estimates of the civilian noninstitutionalized population as of July 1. Rates using the civilian noninstitutionalized population will be overestimated to the extent that visits
by institutionalized persons are counted in the numerator (for example, hospital emergency department visits by nursing home residents) but institutionalized persons
are omitted from the denominator (the civilian noninstitutionalized population). Starting with Health, United States, 2005, data for physician offices for 2001 and beyond
use a revised weighting scheme. See Appendix I, National Ambulatory Medical Care Survey (NAMCS); National Hospital Ambulatory Medical Care Survey (NHAMCS).
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. See Appendix I, National Ambulatory Medical Care
Survey (NAMCS); National Hospital Ambulatory Medical Care Survey (NHAMCS).
Age, sex, and race 1980 2000 2010 2013 2 1980 2000 2010 2013 2 1980 2000 2010 2013 2
Age, sex, and race 1980 2000 2010 2013 2 1980 2000 2010 2013 2 1980 2000 2010 2013 2
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have a RSE greater than 30%.
1
Type of physician is based on physician's self-designated primary area of practice. Primary care generalist physicians are defined as practitioners in the fields of
general and family practice, general internal medicine, general obstetrics and gynecology, and general pediatrics and exclude primary care specialists. Primary
care generalists in general and family practice exclude primary care specialties, such as sports medicine and geriatrics. Primary care internal medicine physicians
exclude internal medicine specialists, such as allergists, cardiologists, and endocrinologists. Primary care obstetrics and gynecology physicians exclude obstetrics
and gynecology specialties, such as gynecological oncology, maternal and fetal medicine, obstetrics and gynecology critical care medicine, and reproductive
endocrinology. Primary care pediatricians exclude pediatric specialists, such as adolescent medicine specialists, neonatologists, pediatric allergists, and pediatric
cardiologists. See Appendix II, Physician specialty.
2
In 2012 and 2013, data exclude visits to community health centers; in 20062011, data include visits to community health centers (2%3% of visits to physician offices
in 20062011 were to community health centers). Prior to 2006, visits to community health centers were not included in the survey.
3
Estimates by racial group should be used with caution because information on race was collected from medical records. In 2013, race data were missing and
imputed for 30% of visits. Information on the race imputation process used in each data year is available in the public-use file documentation. Available from:
http://www.cdc.gov/nchs/ahcd.htm. Starting with 1999 data, the instruction for the race item on the Patient Record Form was changed so that more than one
race could be recorded. In previous years only one racial category could be checked. Estimates for racial groups presented in this table are for visits where only
one race was recorded. Because of the small number of responses with more than one racial group checked, estimates for visits with multiple races checked are
unreliable and are not presented.
NOTES: This table presents data on visits to physician offices and excludes visits to other sites, such as hospital outpatient and emergency departments. See
Appendix II, Office visit. In 1980, the survey excluded Alaska and Hawaii. Data for all other years include all 50 states and the District of Columbia. Visits with specialty
of physician unknown are excluded. Starting with Health, United States, 2005, data for 2001 and later years for physician offices use a revised weighting scheme. See
Appendix I, National Ambulatory Medical Care Survey (NAMCS). Data for additional years are available. See the Excel spreadsheet on the Health, United States website
at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Ambulatory Medical Care Survey. See Appendix I, National Ambulatory Medical Care Survey (NAMCS).
2 years and over 217 years 1864 years 65 years and over 1
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015 1997 2010 2015
Hispanic or Latino . . . . . . . . . . . . 54.0 56.5 62.2 61.0 74.8 83.8 50.8 48.5 53.2 47.8 42.1 52.2
Not Hispanic or Latino. . . . . . . . . . 66.4 66.2 69.5 74.7 80.1 85.0 65.7 63.4 66.2 55.2 59.0 63.6
White only. . . . . . . . . . . . . . . 68.0 67.6 70.4 76.4 80.9 85.4 67.5 65.4 67.4 57.2 60.9 66.1
Black or African American only . . . . 58.8 58.7 64.3 68.8 79.2 85.1 56.9 53.1 59.4 35.3 40.5 46.8
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . 50.5 50.6 55.8 62.0 73.2 82.2 46.9 41.0 45.0 31.5 32.8 35.9
100%199%. . . . . . . . . . . . . . . 50.8 51.6 55.4 62.5 73.4 81.2 48.3 44.1 47.1 40.8 43.8 44.0
200%399%. . . . . . . . . . . . . . . 66.2 63.5 66.4 76.1 79.0 84.1 63.4 59.6 61.8 60.7 57.9 61.3
400% or more . . . . . . . . . . . . . . 78.9 79.3 81.2 85.7 88.0 90.1 77.7 77.5 79.2 74.7 77.2 80.8
Hispanic origin and race and
percent of poverty level 4,5
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . 45.7 50.8 58.5 55.9 74.3 85.2 39.2 34.7 40.8 33.6 32.4 41.3
100%199% . . . . . . . . . . . . . 47.2 50.8 57.1 53.8 71.1 83.8 43.5 40.2 44.7 47.9 39.5 42.9
200%399% . . . . . . . . . . . . . 61.2 59.1 61.8 70.5 76.5 79.1 57.5 54.1 56.4 57.0 46.0 54.2
400% or more . . . . . . . . . . . . 73.0 73.3 77.7 82.4 84.2 89.3 70.8 71.6 74.8 64.9 54.3 74.4
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . 51.7 49.3 52.6 64.4 69.1 78.5 50.6 44.4 46.9 32.0 36.4 35.4
100%199% . . . . . . . . . . . . 52.4 52.7 52.4 66.1 75.3 78.7 50.4 47.2 45.3 42.2 45.4 45.2
200%399% . . . . . . . . . . . . 67.5 64.7 67.5 77.1 79.6 85.1 65.0 61.4 62.9 61.9 59.8 63.7
400% or more . . . . . . . . . . . 79.7 79.8 82.0 86.8 88.6 90.9 78.5 77.9 80.1 75.5 78.8 81.9
Black or African American only:
Below 100% . . . . . . . . . . . . 52.8 52.0 57.1 66.1 78.0 82.9 46.2 39.7 44.8 27.7 20.9 31.2
100%199% . . . . . . . . . . . . 48.7 50.0 58.7 61.2 75.9 84.0 46.3 41.5 52.3 26.9 33.6 36.7
200%399% . . . . . . . . . . . . 63.3 61.2 65.5 75.0 81.2 88.2 60.7 57.2 62.0 41.5 45.3 48.0
400% or more . . . . . . . . . . . 74.6 77.2 77.3 81.8 87.2 88.2 73.4 75.9 75.8 66.1 69.8 72.4
See footnotes at end of table.
2 years and over 217 years 1864 years 65 years and over 1
Characteristic 1997 2010 2015 1997 2010 2015 1997 2010 2015 1997 2010 2015
Disability measure 6 Percent of persons with a dental visit in the past year 2
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . ... ... ... ... ... ... 55.1 53.5 55.1 49.0 50.7 56.0
Any basic actions difficulty . . . . . . ... ... ... ... ... ... 54.7 53.2 55.1 48.7 50.5 55.7
Any complex activity limitation . . . . ... ... ... ... ... ... 51.0 47.4 48.4 44.6 43.1 49.1
No disability . . . . . . . . . . . . . . . ... ... ... ... ... ... 67.4 64.2 67.2 64.2 68.8 73.3
Geographic region
Northeast . . . . . . . . . . . . . . . . 69.6 70.1 72.6 77.5 83.8 86.8 69.6 67.9 70.9 55.5 61.5 62.8
Midwest . . . . . . . . . . . . . . . . . 68.4 67.3 69.3 76.4 80.8 83.8 67.4 64.3 65.3 57.6 58.2 64.8
South . . . . . . . . . . . . . . . . . . 60.2 60.9 64.9 68.0 77.4 84.7 59.4 56.5 59.2 49.0 54.1 60.1
West . . . . . . . . . . . . . . . . . . . 65.0 63.9 69.3 71.5 76.1 84.2 62.9 60.2 65.1 61.9 59.8 65.4
Location of residence 7
Within MSA . . . . . . . . . . . . . . . 66.7 65.9 69.4 73.6 79.3 84.9 65.7 62.4 65.3 57.6 59.4 64.6
Outside MSA . . . . . . . . . . . . . . 59.1 58.4 60.8 69.3 76.4 83.3 58.0 53.8 55.0 46.1 51.3 54.2
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
Based on the 19972015 National Health Interview Surveys, about 19%30% of persons aged 65 and over were edentulous (having lost all their natural teeth). In
19972015, about 69%73% of older dentate persons, compared with 17%24% of older edentate persons, had a dental visit in the past year.
2
Respondents were asked, "About how long has it been since you last saw or talked to a dentist?" See Appendix II, Dental visit.
3
Includes all other races not shown separately and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
7
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, sample child and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
At least one prescription drug Three or more prescription drugs Five or more prescription drugs
in past 30 days in past 30 days in past 30 days
1988 1999 2007 2011 1988 1999 2007 2011 1988 1999 2007 2011
Sex, race and Hispanic origin, 1 and age 1994 2002 2010 2014 1994 2002 2010 2014 1994 2002 2010 2014
NOTES: See Appendix II, Drug. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
All ages Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . 1.7 6.5 14.3 1.5 7.1 15.0 1.8 5.8 13.7
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 7.2 9.4 9.1 5.4 7.3 7.6 9.0 11.3 10.5
Antidepressants (depression and related disorders) . . . 1.8 6.4 10.7 1.2 4.4 7.3 2.3 8.3 13.9
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 2.8 5.3 8.5 2.4 4.7 7.5 3.0 5.9 9.4
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 4.4 7.7 2.7 4.1 7.1 3.5 4.6 8.4
ACE inhibitors (high blood pressure, heart disease). . . . 2.4 4.6 7.3 2.4 4.7 8.1 2.4 4.5 6.6
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . 2.6 3.7 6.6 2.5 3.7 6.8 2.6 3.8 6.3
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . 3.4 4.1 5.6 2.3 3.1 4.4 4.4 5.1 6.7
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 2.3 3.9 5.1 0.8 1.5 1.9 3.7 6.2 8.0
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . 2.6 3.5 4.6 2.5 3.1 4.5 2.7 3.8 4.6
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 9.8 15.2 8.7
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . 2.8 3.3 5.3 1.9 2.6 4.4 3.6 4.0 6.2
Antihypertensive combinations (high blood pressure) . . 2.4 2.9 4.1 1.4 1.9 3.3 3.3 3.8 4.8
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 2.4 4.9 1.2 2.1 4.3 1.6 2.7 5.5
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 4.2 4.7 3.4 3.5 4.6 3.8 4.8 4.7
Under 18 years
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . 3.0 4.0 4.4 3.3 4.4 4.9 2.7 3.6 3.9
CNS stimulants (attention-deficit/hyperactivity disorder) . *0.8 2.9 3.4 *1.2 4.4 5.0 * 1.4 1.7
Penicillins (bacterial infections) . . . . . . . . . . . . . . . . 6.1 5.1 2.6 5.9 5.2 2.0 6.4 5.0 3.2
Leukotriene modifiers (asthma, allergies) . . . . . . . . . . ... 0.7 2.1 ... *0.9 2.5 ... * 1.7
Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . 2.0 4.4 2.0 2.1 4.9 2.3 1.9 3.9 1.8
Respiratory inhalant products (asthma, chronic
obstructive pulmonary disease, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . *0.7 1.5 1.9 * 1.7 2.4 * 1.3 *1.3
Adrenal cortical steroids (anti-inflammatory) . . . . . . . . *0.5 0.8 1.0 * *0.7 *1.0 *0.5 0.9 *1.1
Nasal preparations (nose symptoms) . . . . . . . . . . . . * 1.1 1.7 * *1.3 2.2 * 1.0 *
Antidepressants (depression and related disorders) . . . * 1.8 *1.3 * 2.2 *0.7 * *1.5 *
Upper respiratory combinations (cough and cold,
congestion) . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 2.3 * 2.6 *2.4 * 2.0 *2.2 *
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 1.2 1.4 1.1 *1.2 1.3 *1.0 1.4 1.6 *1.3
Dermatological agents (skin symptoms) . . . . . . . . . . 0.7 1.1 1.1 * 1.1 *0.9 *1.0 *1.1 1.4
1844 years
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 7.2 8.0 7.0 5.1 6.0 5.3 9.1 9.9 8.8
Antidepressants (depression and related disorders) . . . 1.6 6.0 8.8 *1.0 3.6 6.4 2.3 8.5 11.2
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 11.5 13.5 13.4
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 2.0 3.0 3.8 1.6 3.0 4.2 2.4 3.0 3.4
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . 1.4 2.1 4.2 *1.0 *1.7 3.5 1.9 2.5 5.0
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.8 1.6 4.1 *0.6 1.6 4.0 1.0 *1.5 4.2
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . 1.4 2.2 2.9 *1.1 1.6 2.6 *1.8 2.8 3.2
Antihyperlipidemic agents (high cholesterol) . . . . . . . . *0.4 1.3 2.3 * 2.0 2.9 * * 1.8
Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . 2.5 3.9 1.8 1.8 3.6 *1.6 3.2 4.2 *2.0
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 1.3 1.6 2.2 * * *0.7 2.1 2.8 3.6
ACE inhibitors (high blood pressure, heart disease). . . . 0.7 1.4 2.1 *0.9 1.5 2.1 *0.6 *1.2 2.2
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . *1.0 1.5 2.5 * *1.5 2.1 *1.0 *1.6 2.9
Muscle relaxants (muscle spasm and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 1.3 1.7 *1.3 *1.1 1.4 *0.7 *1.4 2.1
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 *1.2 1.6 *0.9 *1.3 1.2 1.3 * 2.0
Nasal preparations (nose symptoms) . . . . . . . . . . . . *0.6 1.5 1.4 * *1.2 *0.8 *0.7 1.7 2.1
See footnotes at end of table.
4564 years Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . 4.3 13.8 25.6 4.4 17.2 28.2 4.2 10.7 23.1
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 5.2 9.9 14.1 5.3 8.4 12.7 5.2 11.3 15.4
Antidepressants (depression and related disorders) . . . 3.5 10.5 17.5 *2.3 7.0 12.5 4.6 13.8 22.2
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 19.9 30.3 10.1
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 11.9 16.0 15.5 9.2 13.5 14.3 14.3 18.3 16.7
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 8.7 11.5 7.0 7.8 10.8 6.2 9.5 12.1
ACE inhibitors (high blood pressure, heart disease). . . . 5.2 8.8 12.5 5.7 9.8 14.9 4.6 7.9 10.2
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . 5.5 7.0 11.3 5.9 7.8 12.5 5.1 6.3 10.2
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 4.7 6.6 8.1 *1.2 *2.7 *2.6 8.1 10.1 13.2
Antihypertensive combinations (high blood pressure) . . 5.3 5.6 7.9 3.3 *3.7 7.4 7.1 7.3 8.3
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . 6.0 6.2 8.6 4.3 4.9 7.7 7.5 7.4 9.4
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . 6.1 6.6 8.6 4.8 4.8 7.2 7.3 8.3 9.9
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 4.3 7.5 *2.5 3.5 6.3 2.9 5.1 8.6
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . 3.4 3.8 5.2 2.9 3.1 *4.6 3.8 4.5 5.8
Calcium channel blocking agents (high blood
pressure, heart disease) . . . . . . . . . . . . . . . . . . . 7.0 6.7 6.6 8.2 5.9 7.9 5.9 7.5 5.4
65 years and over
Antihyperlipidemic agents (high cholesterol) . . . . . . . . 5.9 23.4 50.3 5.3 24.3 54.4 6.4 22.7 47.1
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 15.9 30.5 10.4 17.5 31.4 12.8 14.8 29.8
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . 16.2 19.2 21.1 12.2 17.1 19.0 19.1 20.7 22.7
ACE inhibitors (high blood pressure, heart disease). . . . 9.5 16.9 24.1 9.8 18.0 28.1 9.3 16.1 21.0
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 7.5 14.6 23.2 7.2 14.1 19.8 7.7 15.0 25.9
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . 9.0 12.4 19.5 9.0 12.9 22.6 9.0 12.0 17.1
Anticoagulants or antiplatelet agents (blood clot
prevention) 5 . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 9.1 14.6 6.8 11.5 17.8 5.6 7.4 12.1
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 13.8 18.4 16.4 11.4 15.0 14.2 15.6 20.9 18.2
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 16.1 19.1 17.8 14.5 17.4 16.7 17.3 20.4 18.7
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 7.0 14.3 15.5 3.3 6.7 7.7 9.7 19.8 21.7
Antihypertensive combinations (high blood pressure) . . 9.6 9.8 11.7 6.0 7.4 8.0 12.2 11.6 14.6
Antidepressants (depression and related disorders) . . . 3.0 9.3 18.9 *2.3 7.2 12.0 3.5 10.8 24.4
Angiotensin II inhibitors (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . ... 4.8 12.2 ... 4.1 11.8 ... 5.3 12.6
Antiarrhythmic agents (heart rhythm irregularities) . . . . 23.1 16.6 8.8 21.6 17.9 8.4 24.3 15.6 9.0
6574 years
Antihyperlipidemic agents (high cholesterol) . . . . . . . . 7.3 26.2 49.1 6.2 26.6 51.9 8.1 25.9 46.7
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 14.8 25.8 10.6 16.0 27.9 11.9 13.9 24.1
ACE inhibitors (high blood pressure, heart disease). . . . 9.6 17.2 23.5 10.6 18.1 28.9 8.9 16.4 18.9
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 7.0 14.7 20.7 6.3 13.4 18.3 7.5 15.8 22.8
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . 8.8 12.9 19.9 8.0 13.8 22.5 9.4 12.0 17.7
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . 14.2 15.9 17.2 10.8 14.6 14.6 17.0 16.9 19.4
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 13.0 18.5 16.8 10.5 14.9 15.3 15.0 21.4 18.0
Antihypertensive combinations (high blood pressure) . . 8.1 8.0 11.8 4.8 *6.7 8.5 10.8 9.0 14.5
Anticoagulants or antiplatelet agents (blood clot
prevention) 5 . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 6.7 10.7 6.3 9.8 *13.8 4.6 *4.2 8.1
Antidepressants (depression and related disorders) . . . 2.8 9.3 18.7 *2.3 5.8 12.6 3.1 12.1 23.9
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 15.0 16.1 14.4 14.0 15.3 15.0 15.8 16.8 13.9
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 6.4 13.0 14.6 *3.4 *5.0 *7.3 8.9 19.7 20.8
Angiotensin II inhibitors (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . ... 4.2 11.1 ... *3.5 9.5 ... 4.9 12.4
Antiarrhythmic agents (heart rhythm irregularities) . . . . 20.2 13.0 6.4 19.0 15.5 *5.8 21.1 10.8 6.9
See footnotes at end of table.
75 years and over Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . 3.8 19.9 48.2 *3.5 21.1 55.7 4.0 19.2 43.1
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . 12.5 17.3 37.9 9.8 19.6 37.6 14.1 15.8 38.1
Diuretics (high blood pressure, heart disease,
kidney disease . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 23.2 25.4 14.7 20.5 24.5 21.9 24.9 26.1
ACE inhibitors (high blood pressure, heart disease). . . . 9.3 16.4 25.0 8.5 17.7 27.0 9.8 15.6 23.7
Anticoagulants or antiplatelet agents (blood clot
prevention) 5 . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 12.0 20.1 7.8 13.9 24.1 6.9 10.9 17.4
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . 8.3 14.6 26.8 9.0 15.3 22.3 7.9 14.2 30.0
Calcium channel blocking agents (high blood
pressure, heart disease) . . . . . . . . . . . . . . . . . . . 17.8 22.8 22.6 15.3 20.5 19.4 19.2 24.2 24.9
Thyroid hormones (hypothyroidism) . . . . . . . . . . . . . 7.9 15.8 16.8 3.0 9.2 8.2 10.9 20.0 22.9
Analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 15.1 18.4 16.0 13.0 15.1 12.6 16.3 20.4 18.3
Antidiabetic agents (diabetes) . . . . . . . . . . . . . . . . 9.3 11.8 18.9 10.7 11.5 22.8 8.5 12.0 16.3
Antihypertensive combinations (high blood pressure) . . 11.9 12.0 11.5 8.3 *8.2 7.1 14.0 14.4 14.6
Antiarrhythmic agents (heart rhythm irregularities) . . . . 27.7 21.0 12.1 26.3 21.3 12.6 28.6 20.7 11.7
Angiotensin II inhibitors (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . ... 5.4 13.9 ... *4.9 15.2 ... 5.8 12.9
Antidepressants (depression and related disorders) . . . 3.4 9.3 19.2 *2.3 9.2 11.0 4.0 9.4 25.0
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
The drug therapeutic class is based on the December 2014 Lexicon Plus, a proprietary database of Cerner Multum, Inc. Lexicon Plus is a comprehensive database
of all prescription and some nonprescription drug products available in the U.S. drug market. Data on prescription drug use are collected by the National Health and
Nutrition Examination Survey. Respondents were asked if they had taken a prescription drug in the past 30 days. Those who answered "yes" were asked to show the
interviewer the medication containers for all prescriptions. If no container was available, the respondent was asked to verbally report the name of the medication. Each
drugs complete name was recorded and classified. Data presented here are based on the second level classification of prescription drugs. Up to four classes are
assigned to each drug. Drugs classified into more than one class were counted in each class. For more information, see
https://wwwn.cdc.gov/nchs/nhanes/1999-2000/RXQ_DRUG.htm. See Appendix II, Multum Lexicon Plus therapeutic class.
2
The drugs classes proton pump inhibitors (272) and H2 antagonists (94) have been combined because of their similar indications for use.
3
This category includes carbonic anhydrase inhibitors which are primarily used to treat glaucoma.
4
Although sex hormones may be used by males, most are used by females. Therefore, data for sex hormones are only presented for females.
5
The drugs classes anticoagulants (82) and antiplatelet agents (83) have been combined because of their similar indications for use.
NOTES: Some drug classes were not available in 19881994 and are coded as not applicable. See Appendix II, Drug. Standard errors are available in the spreadsheet
version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Percent
1 year and over, age-adjusted . . . . . . . .
2,3
7.8 7.6 7.0 6.4 6.5 1.8 1.8 1.8 1.6 1.7
1 year and over, crude 2 . . . . . . . . . . . . . 7.7 7.5 7.2 6.8 6.9 1.7 1.8 1.9 1.7 1.8
Age
117 years . . . . . . . . . . . . . . . . . . . . 2.8 2.5 2.4 2.0 2.1 0.5 0.4 0.5 0.4 0.3
15 years . . . . . . . . . . . . . . . . . . . 3.9 3.8 3.4 3.0 3.1 0.7 0.7 0.6 0.7 *0.4
617 years . . . . . . . . . . . . . . . . . . 2.3 1.9 1.9 1.6 1.7 0.4 0.3 0.5 0.3 0.3
1844 years . . . . . . . . . . . . . . . . . . . 7.4 7.0 6.3 5.8 5.8 1.2 1.1 1.3 1.1 1.2
1824 years . . . . . . . . . . . . . . . . . . 7.9 7.0 5.7 4.6 4.5 1.3 1.1 1.1 0.9 0.8
2544 years . . . . . . . . . . . . . . . . . . 7.3 7.0 6.6 6.2 6.3 1.2 1.2 1.3 1.1 1.3
4564 years . . . . . . . . . . . . . . . . . . . 8.2 8.4 8.3 7.4 7.7 2.2 2.2 2.5 2.3 2.3
4554 years . . . . . . . . . . . . . . . . . . 6.9 7.3 7.3 6.1 6.4 1.7 1.8 2.1 1.9 1.8
5564 years . . . . . . . . . . . . . . . . . . 10.2 10.0 9.5 8.7 9.2 2.9 2.8 2.9 2.6 2.7
65 years and over . . . . . . . . . . . . . . . . 18.0 18.2 16.1 15.3 15.2 5.4 5.8 4.9 4.3 4.9
6574 years . . . . . . . . . . . . . . . . . . 16.1 16.1 13.6 13.8 12.8 4.8 4.9 3.8 4.0 4.0
75 years and over. . . . . . . . . . . . . . . 20.4 20.7 19.0 17.5 18.8 6.2 6.8 6.2 4.8 6.2
7584 years . . . . . . . . . . . . . . . . 19.8 20.1 18.3 16.1 17.3 6.1 6.2 6.1 4.2 5.7
85 years and over . . . . . . . . . . . . . 22.8 23.4 20.8 20.9 22.5 6.2 9.0 6.6 6.3 7.3
164 years
Total, 164 years 2,4 . . . . . . . . . . . . . . . 6.3 6.1 5.7 5.1 5.2 1.3 1.2 1.3 1.2 1.2
Sex
Male, crude . . . . . . . . . . . . . . . . . . . 4.4 4.2 4.2 3.9 4.2 0.9 1.0 1.1 1.1 1.2
117 years . . . . . . . . . . . . . . . . . . 2.9 2.4 2.4 2.0 2.1 0.6 0.4 0.5 0.5 0.4
1844 years . . . . . . . . . . . . . . . . . . 3.6 3.1 2.9 2.6 3.1 0.6 0.6 0.7 0.6 0.9
4554 years . . . . . . . . . . . . . . . . . . 6.0 7.0 6.4 5.7 5.9 1.4 1.8 1.9 1.8 1.7
5564 years . . . . . . . . . . . . . . . . . . 11.1 10.2 9.3 9.0 9.7 3.0 3.0 2.8 2.8 2.9
Female, crude . . . . . . . . . . . . . . . . . . 8.0 7.9 7.6 6.7 6.6 1.6 1.5 1.7 1.4 1.4
117 years . . . . . . . . . . . . . . . . . . 2.6 2.5 2.3 2.1 2.1 0.5 0.4 0.5 0.4 0.3
1844 years . . . . . . . . . . . . . . . . . . 11.2 10.8 9.8 8.9 8.5 1.8 1.7 1.9 1.5 1.5
4554 years . . . . . . . . . . . . . . . . . . 7.6 7.6 8.3 6.6 6.8 2.0 1.9 2.3 2.0 2.0
5564 years . . . . . . . . . . . . . . . . . . 9.4 9.8 9.7 8.5 8.8 2.9 2.7 2.9 2.5 2.4
Race 4,5
White only . . . . . . . . . . . . . . . . . . . . 6.2 5.9 5.6 5.0 5.1 1.2 1.1 1.3 1.1 1.1
Black or African American only . . . . . . . . . 7.6 7.4 6.7 6.2 6.4 1.9 1.9 1.9 2.1 2.0
American Indian or Alaska Native only . . . . . 7.6 7.0 *7.6 6.6 5.7 * * *2.4 * *
Asian only . . . . . . . . . . . . . . . . . . . . 3.9 3.9 3.6 3.1 3.3 *0.5 *0.6 *0.4 0.5 0.8
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . -- * * * * -- * * * *
2 or more races . . . . . . . . . . . . . . . . . -- 8.8 7.7 5.9 5.7 -- *1.6 *2.4 *1.4 *1.6
Hispanic origin and race 4,5
Hispanic or Latino . . . . . . . . . . . . . . . . 6.8 5.5 5.2 4.5 4.8 1.3 0.9 1.1 1.1 1.2
Not Hispanic or Latino. . . . . . . . . . . . . . 6.2 6.1 5.8 5.2 5.3 1.3 1.3 1.4 1.2 1.2
White only. . . . . . . . . . . . . . . . . . . 6.1 6.0 5.7 5.2 5.3 1.2 1.2 1.3 1.1 1.1
Black or African American only . . . . . . . . 7.5 7.4 6.7 6.2 6.4 1.9 1.9 1.9 2.1 2.0
Percent of poverty level 4,6
Below 100% . . . . . . . . . . . . . . . . . . . 10.3 9.1 8.3 8.1 8.3 2.8 2.6 2.7 2.7 2.9
100%199%. . . . . . . . . . . . . . . . . . . 7.3 7.3 7.0 6.1 6.1 1.7 1.9 1.9 1.7 1.7
200%399%. . . . . . . . . . . . . . . . . . . 6.0 6.0 5.2 4.7 4.9 1.2 1.1 1.1 1.0 1.1
400% or more . . . . . . . . . . . . . . . . . . 4.7 5.0 4.5 3.8 4.1 0.7 0.8 0.8 0.6 0.6
See footnotes at end of table.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%30%. Data not shown have an RSE greater than 30%.
1
These estimates exclude hospitalizations for institutionalized persons and those who died while hospitalized, because they are outside the scope of this survey. See
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Type of ownership
and size of hospital 1975 1980 1990 2000 2010 2012 2013 2014
SOURCE: American Hospital Association (AHA). Annual Survey of Hospitals. Hospital Statistics, 1976, 1981, 199192, 2002, 2012, 2014, 2015, and 2016 editions.
Chicago, IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1976, 1981, 199192, 2002, 2012, 2014, 2015, and 2016 editions by Health Forum, LLC,
an American Hospital Association Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
1
Includes active doctors of medicine (MDs) and active doctors of osteopathy (DOs). See Appendix II, Physician.
2
Starting with 2003 data, federal and nonfederal physicians are included. Data prior to 2003 included nonfederal physicians only.
3
Prior to 2006, excludes DOs. Excludes physicians in medical teaching, administration, research, and other nonpatient care activities. Includes residents.
4
Data for DOs are as of January 2001.
NOTES: Data for MDs are as of December 31. Data for DOs are as of May 31, unless otherwise specified. Starting with Health, United States, 2012, data for DOs for
2009 and beyond are from the American Medical Association (AMA). Prior to 2009, data for DOs are from the American Osteopathic Association (AOA).
SOURCE: American Medical Association (AMA): Physician distribution and medical licensure in the U.S., 1975; Physician characteristics and distribution in the U.S.,
1986, 20022003, 2012, 2014, and 2015 editions; Department of Physician Practice and Communications Information, Division of Survey and Data Resources, AMA.
(Copyright 1976, 1986, 2003, 2012, 2014, and 2015: Used with permission of the AMA); American Osteopathic Association: 19751976 Yearbook and Directory of
Osteopathic Physicians, 19851986 Yearbook and Directory of Osteopathic Physicians. See Appendix I, American Medical Association (AMA) Physician Masterfile;
Place of medical education and activity 1975 1985 1995 2000 2005 2010 2012 2013
1
Doctors of medicine who are inactive, have unknown address, or primary specialty not classified are excluded. See Appendix II, Physician.
2
International medical graduates received their medical education in schools outside of the United States and Canada.
3
Specialty information is based on the physician's self-designated primary area of practice. Categories include generalists and specialists. See Appendix II, Physician
specialty.
4
Starting with 2003 data, federal and nonfederal doctors of medicine are included. Data prior to 2003 included nonfederal doctors of medicine only.
5
Starting with 1990 data, clinical fellows are included in this category. In prior years, clinical fellows were included in the other professional activity category.
6
Includes doctors of medicine in medical teaching, administration, research, and other nonpatient care activities. Prior to 1990, this category also included clinical fellows.
NOTES: Data for doctors of medicine are as of December 31. Outlying areas include Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific islands.
SOURCE: American Medical Association (AMA). Physician distribution and medical licensure in the U.S., 1975; Physician characteristics and distribution in the U.S.,
1986, 19961997, 20022003, 2007, 2012, 2014, and 2015 editions, Department of Physician Practice and Communications Information, Division of Survey and Data
Resources, AMA. (Copyright 1976, 1986, 1997, 2003, 2007, 2012, 2014, and 2015: Used with permission of the AMA.) See Appendix I, American Medical Association
(AMA) Physician Masterfile.
Specialty 1949 1 1960 1 1970 1980 1990 2000 2010 2012 2013
Number
Total doctors of medicine 2 . . . . . . . . . . . 201,277 260,484 334,028 467,679 615,421 813,770 985,375 1,026,788 1,045,910
Active doctors of medicine 3 . . . . . . . . . . 191,577 247,257 310,845 414,916 547,310 692,368 794,862 826,001 854,698
General primary care specialists . . . . . . 113,222 125,359 134,354 170,705 213,514 274,653 304,687 313,793 319,881
General practice/family medicine . . . . 95,980 88,023 57,948 60,049 70,480 86,312 94,746 96,552 98,298
Internal medicine . . . . . . . . . . . . . . 12,453 26,209 39,924 58,462 76,295 101,353 113,591 118,504 121,127
Obstetrics/Gynecology . . . . . . . . . . -- -- 18,532 24,612 30,220 35,922 38,520 39,324 40,045
Pediatrics . . . . . . . . . . . . . . . . . . 4,789 11,127 17,950 27,582 36,519 51,066 57,830 59,413 60,411
Primary care subspecialists . . . . . . . . . -- -- 3,161 16,642 30,911 52,294 76,122 83,532 90,147
Family medicine. . . . . . . . . . . . . . . -- -- -- -- -- 483 1,445 1,764 1,991
Internal medicine . . . . . . . . . . . . . . -- -- 1,948 13,069 22,054 34,831 50,730 55,357 59,256
Obstetrics/Gynecology . . . . . . . . . . -- -- 344 1,693 3,477 4,319 4,277 4,186 4,141
Pediatrics . . . . . . . . . . . . . . . . . . -- -- 869 1,880 5,380 12,661 19,670 22,225 24,759
Percent of active doctors of medicine
General primary care specialists . . . . . . 59.1 50.7 43.2 41.1 39.0 39.7 38.3 38.0 37.4
General practice/family medicine . . . . 50.1 35.6 18.6 14.5 12.9 12.5 11.9 11.7 11.5
Internal medicine . . . . . . . . . . . . . . 6.5 10.6 12.8 14.1 13.9 14.6 14.3 14.3 14.2
Obstetrics/Gynecology . . . . . . . . . . -- -- 6.0 5.9 5.5 5.2 4.8 4.8 4.7
Pediatrics . . . . . . . . . . . . . . . . . . 2.5 4.5 5.8 6.6 6.7 7.4 7.3 7.2 7.1
Primary care subspecialists . . . . . . . . . -- -- 1.0 4.0 5.6 7.6 9.6 10.1 10.5
Family medicine. . . . . . . . . . . . . . . -- -- -- -- -- 0.1 0.2 0.2 0.2
Internal medicine . . . . . . . . . . . . . . -- -- 0.6 3.1 4.0 5.0 6.4 6.7 6.9
Obstetrics/Gynecology . . . . . . . . . . -- -- 0.1 0.4 0.6 0.6 0.5 0.5 0.5
Pediatrics . . . . . . . . . . . . . . . . . . -- -- 0.3 0.5 1.0 1.8 2.5 2.7 2.9
1
Estimated by the Bureau of Health Professions, Health Resources and Services Administration. Active doctors of medicine (MDs) include those with address unknown
2
Data on federal and nonfederal doctors of medicine engaged in office- or hospital-based patient care and other professional activities.
3
Starting with 1970 data, MDs who are inactive, have unknown address, or primary specialty not classified are excluded. See Appendix II, Physician.
NOTES: See Appendix II, Physician specialty. Data are as of December 31 except for 19901994 data, which are as of January 1, and 1949 data, which are as of
midyear. Outlying areas include Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific islands.
SOURCE: Health Manpower Source Book: Medical Specialists, USDHEW, 1962; American Medical Association (AMA). Distribution of physicians in the United States,
1970; Physician characteristics and distribution in the U.S., 1981, 1992, 20022003, 2011, 2012, 2014, and 2015 editions, Department of Physician Practice and
Communications Information, Division of Survey and Data Resources, AMA. (Copyright 1971, 1982, 1992, 2003, 2012, 2014, and 2015: Used with permission of the
AMA.) See Appendix I, American Medical Association (AMA) Physician Masterfile.
State 2001 2006 2013 2014 2015 2001 2006 2013 2014 2015
Number of dentists Number of dentists per 100,000 civilian population
United States . . . . . . . . . . . . 163,345 172,603 191,347 192,313 195,722 57.32 57.85 60.47 60.30 60.89
Alabama . . . . . . . . . . . . . . 1,880 1,921 2,128 2,125 2,130 42.08 41.50 44.05 43.85 43.84
Alaska . . . . . . . . . . . . . . . 457 489 577 588 597 72.11 72.41 78.24 79.78 80.85
Arizona . . . . . . . . . . . . . . 2,374 3,061 3,617 3,627 3,677 45.02 50.77 54.55 53.90 53.85
Arkansas . . . . . . . . . . . . . 1,047 1,114 1,210 1,204 1,219 38.90 39.48 40.91 40.58 40.93
California . . . . . . . . . . . . . 22,709 26,388 29,425 29,530 30,180 65.86 73.26 76.60 76.12 77.10
Colorado . . . . . . . . . . . . . 2,844 3,098 3,623 3,692 3,801 64.26 65.63 68.73 68.94 69.66
Connecticut. . . . . . . . . . . . 2,590 2,587 2,742 2,692 2,723 75.45 73.55 76.23 74.89 75.83
Delaware . . . . . . . . . . . . . 352 383 420 426 431 44.24 44.57 45.39 45.51 45.56
District of Columbia . . . . . . . 603 533 579 580 604 104.96 93.40 89.14 87.90 89.85
Florida . . . . . . . . . . . . . . . 8,158 8,754 9,947 10,223 10,543 49.87 48.19 50.76 51.36 52.01
Georgia . . . . . . . . . . . . . . 3,614 4,115 4,701 4,731 4,805 43.14 44.94 47.05 46.85 47.04
Hawaii . . . . . . . . . . . . . . . 1,022 1,009 1,060 1,069 1,083 83.36 77.04 75.24 75.27 75.65
Idaho. . . . . . . . . . . . . . . . 690 864 932 907 939 52.27 58.83 57.79 55.48 56.74
Illinois . . . . . . . . . . . . . . . 8,154 7,994 8,599 8,593 8,697 65.29 63.22 66.71 66.70 67.63
Indiana. . . . . . . . . . . . . . . 2,870 2,842 3,116 3,104 3,157 46.84 44.88 47.42 47.05 47.69
Iowa . . . . . . . . . . . . . . . . 1,516 1,526 1,604 1,611 1,652 51.71 51.16 51.87 51.81 52.88
Kansas . . . . . . . . . . . . . . 1,314 1,347 1,461 1,471 1,482 48.63 48.75 50.47 50.68 50.90
Kentucky . . . . . . . . . . . . . 2,256 2,287 2,488 2,441 2,445 55.46 54.20 56.56 55.32 55.25
Louisiana . . . . . . . . . . . . . 2,058 2,017 2,221 2,199 2,262 45.96 46.88 48.00 47.30 48.43
Maine . . . . . . . . . . . . . . . 598 642 693 669 674 46.51 48.50 52.15 50.29 50.70
Maryland . . . . . . . . . . . . . 3,955 3,989 4,268 4,260 4,322 73.59 70.89 71.90 71.29 71.96
Massachusetts . . . . . . . . . . 4,898 4,797 5,232 5,303 5,319 76.56 74.84 77.99 78.50 78.28
Michigan . . . . . . . . . . . . . 5,783 5,928 6,075 6,010 6,056 57.88 59.07 61.36 60.61 61.03
Minnesota . . . . . . . . . . . . . 2,880 3,105 3,284 3,288 3,312 57.80 60.13 60.58 60.25 60.33
Mississippi . . . . . . . . . . . . 1,117 1,140 1,275 1,264 1,284 39.15 39.24 42.63 42.23 42.91
Missouri . . . . . . . . . . . . . . 2,634 2,666 2,900 2,952 2,943 46.69 45.63 47.98 48.68 48.38
Montana . . . . . . . . . . . . . . 511 525 598 612 619 56.34 55.11 58.95 59.81 59.93
Nebraska . . . . . . . . . . . . . 1,103 1,117 1,203 1,223 1,250 64.13 63.01 64.36 64.95 65.92
Nevada . . . . . . . . . . . . . . 846 1,177 1,448 1,446 1,525 40.32 46.66 51.89 50.95 52.75
New Hampshire . . . . . . . . . 735 815 847 830 851 58.54 62.29 64.04 62.50 63.96
New Jersey . . . . . . . . . . . . 6,054 6,922 7,238 7,256 7,303 71.28 79.92 81.26 81.17 81.52
New Mexico . . . . . . . . . . . 814 861 1,062 1,065 1,060 44.44 43.88 50.89 51.07 50.84
New York . . . . . . . . . . . . . 14,309 14,062 14,468 14,428 14,560 74.98 73.61 73.48 73.06 73.55
North Carolina . . . . . . . . . . 3,474 4,016 4,719 4,791 5,038 42.31 45.04 47.93 48.20 50.17
North Dakota . . . . . . . . . . . 305 311 394 405 419 47.73 47.89 54.45 54.73 55.36
Ohio . . . . . . . . . . . . . . . . 5,929 5,797 6,003 5,978 6,078 52.07 50.49 51.87 51.55 52.34
Oklahoma . . . . . . . . . . . . . 1,664 1,749 1,943 1,937 1,966 47.99 48.66 50.42 49.93 50.26
Oregon . . . . . . . . . . . . . . 2,197 2,431 2,708 2,700 2,785 63.35 66.22 68.94 67.99 69.12
Pennsylvania . . . . . . . . . . . 7,595 7,454 7,698 7,783 7,774 61.75 59.58 60.22 60.83 60.72
Rhode Island . . . . . . . . . . . 588 576 566 553 572 55.62 54.18 53.76 52.42 54.15
South Carolina . . . . . . . . . . 1,839 1,958 2,288 2,229 2,350 45.24 44.93 47.98 46.16 48.00
South Dakota . . . . . . . . . . . 348 382 457 460 460 45.91 48.78 54.07 53.91 53.58
Tennessee . . . . . . . . . . . . 2,912 2,947 3,246 3,252 3,273 50.64 48.40 49.97 49.67 49.59
Texas . . . . . . . . . . . . . . . 9,642 10,365 13,391 13,692 14,268 45.23 44.37 50.53 50.75 51.94
Utah . . . . . . . . . . . . . . . . 1,409 1,559 1,892 1,864 1,885 61.70 61.73 65.16 63.30 62.92
Vermont . . . . . . . . . . . . . . 354 343 365 347 355 57.82 55.07 58.20 55.36 56.71
Virginia . . . . . . . . . . . . . . 4,189 4,367 5,194 5,277 5,329 58.19 56.91 62.82 63.36 63.57
Washington . . . . . . . . . . . . 3,957 4,312 4,951 5,050 5,219 66.11 67.68 71.00 71.50 72.79
West Virginia . . . . . . . . . . . 863 835 890 881 897 47.91 45.68 48.03 47.65 48.64
Wisconsin . . . . . . . . . . . . . 3,069 2,860 3,215 3,202 3,193 56.76 51.28 55.97 55.60 55.33
Wyoming . . . . . . . . . . . . . 266 266 309 323 317 53.77 50.89 52.99 55.28 54.09
NOTES: Data include professionally active dentists only. Professionally active dentists include those whose primary occupation is one of the following: private practice
(full- or part-time), dental school/faculty staff member, armed forces, other federal services (i.e., Veterans' Affairs, Public Health Service), state or local government
employee, hospital staff dentist, graduate student/intern/resident, or other health/dental organization staff member. U.S. totals include dentists with unknown state of
practice not shown separately and may include missing data. Starting with Health, United States, 2016, data on the number of dentists per 100,000 civilian population
for 2011 and beyond are calculated using 2010-based postcensal estimates, data for 2010 are calculated using the April 1, 2010 census counts, and data for 2001
2009 are calculated using the the intercensal estimates based on the 2000 and 2010 censuses.
SOURCE: American Dental Association, Health Policy Institute, Dentist Supply in the US: 20012015, Tables 1 and 3 (Copyright 2016 American Dental Association.
Reprinted with permission. All rights reserved.). Any form of reproduction is strictly prohibited without prior written permission of the American Dental Association. See
Appendix I, American Dental Association (ADA).
Occupation title 2000 2010 2014 2015 2000 2010 2014 2015
Healthcare practitioners and
technical occupations Employment 1 Mean hourly wage 2
Audiologists . . . . . . . . . . . . . . . . . . . . 11,530 12,860 12,250 12,070 $22.92 $33.58 $36.92 $37.22
Cardiovascular technologists and
technicians . . . . . . . . . . . . . . . . . . . . 40,080 48,720 51,080 51,400 16.81 24.38 26.54 26.97
Dental hygienists . . . . . . . . . . . . . . . . . 148,460 177,520 196,520 200,550 24.99 33.02 34.60 34.96
Diagnostic medical sonographers . . . . . . . 31,760 53,010 59,760 61,250 22.03 31.20 32.88 34.08
Dietetic technicians. . . . . . . . . . . . . . . . 28,010 23,890 28,690 28,950 10.98 13.86 13.75 14.03
Dietitians and nutritionists . . . . . . . . . . . . 43,030 53,510 59,490 59,740 18.76 26.13 27.62 28.08
Emergency medical technicians and
paramedics . . . . . . . . . . . . . . . . . . . . 165,530 221,760 235,760 236,890 11.89 16.01 16.88 17.04
Licensed practical and licensed
vocational nurses . . . . . . . . . . . . . . . . 679,470 730,290 695,610 697,250 14.65 19.88 20.87 21.17
Magnetic resonance imaging
technologists. . . . . . . . . . . . . . . . . . . -- -- 33,130 33,460 -- -- 32.36 32.86
Medical and clinical laboratory
technicians . . . . . . . . . . . . . . . . . . . . 146,060 156,480 160,460 157,610 13.93 18.36 19.59 19.91
Medical and clinical laboratory
technologists. . . . . . . . . . . . . . . . . . . 144,530 164,430 161,710 162,950 19.84 27.34 29.12 29.74
Medical records and health
information technicians. . . . . . . . . . . . . 143,870 176,090 184,740 189,930 11.74 16.83 18.68 19.44
Nuclear medicine technologists . . . . . . . . 18,030 21,600 20,320 19,740 21.56 33.20 35.21 36.06
Nurse anesthetists . . . . . . . . . . . . . . . . -- -- 36,590 39,410 -- -- 76.40 77.04
Nurse midwives . . . . . . . . . . . . . . . . . . -- -- 5,110 7,430 -- -- 46.97 45.01
Nurse practitioners . . . . . . . . . . . . . . . . -- -- 122,050 136,060 -- -- 47.11 48.68
Occupational therapists . . . . . . . . . . . . . 75,150 100,300 110,520 114,660 24.10 35.28 38.46 39.27
Opticians, dispensing . . . . . . . . . . . . . . 66,580 62,200 73,110 73,520 12.67 16.73 17.43 17.70
Pharmacists . . . . . . . . . . . . . . . . . . . . 212,660 268,030 290,780 295,620 33.39 52.59 56.96 57.34
Pharmacy technicians . . . . . . . . . . . . . . 190,940 333,500 368,760 379,430 10.38 14.10 14.95 15.23
Physical therapists . . . . . . . . . . . . . . . . 120,410 180,280 200,670 209,690 27.62 37.50 40.35 41.25
Physician assistants . . . . . . . . . . . . . . . 55,490 81,420 91,670 98,470 29.17 41.89 46.77 47.73
Psychiatric technicians . . . . . . . . . . . . . 53,350 72,650 64,540 58,450 12.53 15.15 16.91 17.44
Radiation therapists . . . . . . . . . . . . . . . 13,100 16,590 16,380 16,930 25.59 37.64 40.25 40.61
Radiologic technologists 3 . . . . . . . . . . . . 172,080 216,730 193,400 195,590 17.93 26.80 27.65 28.13
Recreational therapists . . . . . . . . . . . . . 26,940 20,830 17,950 17,880 14.23 19.92 22.14 22.98
Registered nurses 4 . . . . . . . . . . . . . . . . 2,189,670 2,655,020 2,687,310 2,745,910 22.31 32.56 33.55 34.14
Respiratory therapists . . . . . . . . . . . . . . 82,670 109,270 119,410 120,330 18.37 26.54 28.12 28.67
Respiratory therapy technicians . . . . . . . . 28,230 13,570 10,610 10,000 16.46 22.28 23.46 23.90
Speech-language pathologists . . . . . . . . . 82,850 112,530 126,500 131,450 23.31 33.60 36.01 36.97
Healthcare support occupations
Dental assistants . . . . . . . . . . . . . . . . . 250,870 294,030 314,330 323,110 12.86 16.41 17.43 17.75
Home health aides . . . . . . . . . . . . . . . . 561,120 982,840 799,080 820,630 8.71 10.46 10.77 11.00
Massage therapists. . . . . . . . . . . . . . . . 24,620 60,040 87,670 92,090 15.51 19.12 20.09 20.76
Medical assistants . . . . . . . . . . . . . . . . 330,830 523,260 584,970 601,240 11.46 14.31 15.01 15.34
Medical equipment preparers. . . . . . . . . . 32,760 47,310 50,550 50,330 10.68 14.59 16.28 16.80
Medical transcriptionists. . . . . . . . . . . . . 97,330 78,780 61,210 57,830 12.37 16.12 17.11 17.17
Nursing assistants 5 . . . . . . . . . . . . . . . . 1,273,460 1,451,090 1,427,740 1,420,570 9.18 12.09 12.62 12.89
Occupational therapy aides . . . . . . . . . . . 8,890 7,180 8,570 7,570 11.21 14.95 13.96 14.95
Occupational therapy assistants . . . . . . . . 15,910 27,720 32,230 35,460 16.76 24.66 27.53 28.05
Orderlies . . . . . . . . . . . . . . . . . . . . . . -- -- 52,420 52,660 -- -- 12.82 13.26
Pharmacy aides . . . . . . . . . . . . . . . . . . 59,890 49,580 41,240 38,040 9.10 10.98 12.28 13.20
Physical therapist aides . . . . . . . . . . . . . 34,620 45,900 48,730 50,540 10.06 12.02 12.82 13.19
Physical therapist assistants . . . . . . . . . . 44,120 65,960 76,910 81,230 16.52 23.95 26.12 26.56
Psychiatric aides . . . . . . . . . . . . . . . . . 57,680 64,730 72,860 69,550 10.79 12.84 13.67 13.55
NOTES: This table excludes occupations such as dentists, physicians, and chiropractors, which have a large percentage of workers who are self-employed. Challenges
in using Occupational Employment Statistics (OES) data as a time series include changes in the occupational, industrial, and geographical classification systems;
changes in the way data are collected; changes in the survey reference period; and changes in mean wage estimation methodology, as well as permanent features of
the methodology. See Appendix I, Occupational Employment Statistics (OES).
SOURCE: U.S. Department of Labor, Bureau of Labor Statistics. Occupational Employment Statistics. Available from:
http://www.bls.gov/oes/current/oes_nat.htm#29-0000. See Appendix I, Occupational Employment Statistics (OES).
Academic years
Profession 19801981 19901991 20002001 20102011 20122013 20132014 20142015
1
Includes data from schools in Puerto Rico. For Pharmacy, includes data from the University of Puerto Rico School of Pharmacy.
2
Includes new entrants and those repeating the initial year.
3
Starting with 20052006 data, first-year enrollment for pharmacy schools include Pharm.D.1 enrollments only. Pharm.D.1 refers to the Doctor of Pharmacy degree
awarded as the first professional degree. Prior to 2005, first-year enrollment data included Pharm.D.1, B.S. Pharmacy, and B.Pharm. enrollments. It also included
second from last year baccalaureate enrollees and third from last year Pharm.D.1 enrollees. It did not include first-year enrollees in accelerated programs.
4
Prior to 20092010 data, enrollment is provided for the fall. For the 20092010 to 20132014 data, enrollment includes winter, spring, summer, and fall. For 20142015
data, enrollment is provided for the 20142015 academic year.
5
ASPPH data is provided for U.S.-based ASPPH members. 20102011 data reported for 45 schools of public health. 20122013 data reported for 49 schools of public
health. 20132014 data reported for 52 schools and 24 programs of public health. 20142015 data reported for 54 schools and 31 programs of public health.
6
Data for the 20102011 academic year and beyond have been revised and differ from previous editions of Health, United States.
7
Includes graduates receiving the O.D. degree but excludes those of "special" optometry degree programs which include, but are not limited to, accelerated programs
for those entering optometry schools with a doctoral degree, foreign optometry programs, or modified extended programs for those returning to schools after an
absence, changing professional fields, or taking a reduced course load for personal reasons.
8
Includes schools with preliminary and provisional accreditation, in addition to fully accredited schools.
9
Includes programs of public health as Association of Schools & Programs of Public Health members as of 2013 school year.
NOTE: Data on the number of schools and first-year enrollments are reported as of the beginning of the academic year, while data on the number of graduates are
reported as of the end of the academic year.
SOURCE: American Dental Association: 20152016 Survey of Dental Education Series, Report 1: Academic Programs, Enrollment and Graduates. Available from:
http://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education (Copyright 2016 American Dental Association. Reprinted with permission.
All rights reserved.) Any form of reproduction is strictly prohibited without prior written permission of the American Dental Association; Association of American Medical
Colleges (AAMC): AAMC Data Book 2016 - Medical Schools and Teaching Hospitals by the Numbers, Washington, DC. 2016. Table A1 (number of schools) and Table
B1 (number of first-year enrollment students and number of graduates). Used with permission of the AAMC; American Association of Colleges of Osteopathic Medicine:
Trends in Osteopathic Medical School Applicants, Enrollment, and Graduates, 2016. Chevy Chase, MD. 2016. Available from:
http://www.aacom.org/reports-programs-initiatives/aacom-reports. Reprinted with permission from AACOM, All rights reserved; Association of Schools and Colleges of
Optometry: Annual Student Data Report Academic Years 20142015, Annual Student Data Report Academic Years 20152016. Available from:
https://optometriceducation.org/data-surveys. Association of Schools and Colleges of Optometry: Annual Student Data Report Academic Years 20152016. Available
from: https://optometriceducation.org/data-surveys. American Association of Colleges of Pharmacy: Fall 2014 Profile of Pharmacy Students, Fall 2015 Profile of
Pharmacy Students. Available from:
http://www.aacp.org/resources/research/institutionalresearch/Pages/StudentApplications,EnrollmentsandDegreesConferred.aspx; American Association of Colleges
of Podiatric Medicine: Applicant, Matriculant, and Graduate Statistics, 2006 through 2014 and unpublished data. Available from: http://www.aacpm.org. Used with
permission of the AACPM; Association of Schools & Programs of Public Health: unpublished data. Washington, DC. Used with permission of the ASPPH; Bureau
of Health Professions: United States Health Personnel FACTBOOK. Health Resources and Services Administration. Rockville, MD. 2003. See Appendix I, American
Dental Association (ADA); Association of American Medical Colleges (AAMC); American Association of Colleges of Osteopathic Medicine (AACOM); Association of
Schools and Colleges of Optometry (ASCO); American Association of Colleges of Pharmacy (AACP); American Association of Colleges of Podiatric Medicine (AACPM);
Association of Schools & Programs of Public Health (ASPPH).
Type of ownership
and size of hospital 1975 1980 1990 2000 2005 2010 2012 2013 2014
Hospitals Number
All hospitals . . . . . . . . . . . . . . 7,156 6,965 6,649 5,810 5,756 5,754 5,723 5,686 5,627
Federal . . . . . . . . . . . . . . . 382 359 337 245 226 213 211 213 213
Nonfederal 1 . . . . . . . . . . . . . 6,774 6,606 6,312 5,565 5,530 5,541 5,512 5,473 5,414
Community 2 . . . . . . . . . . . 5,875 5,830 5,384 4,915 4,936 4,985 4,999 4,974 4,926
Nonprofit . . . . . . . . . . . 3,339 3,322 3,191 3,003 2,958 2,904 2,894 2,904 2,870
For profit . . . . . . . . . . . 775 730 749 749 868 1,013 1,068 1,060 1,053
State-local government . . . 1,761 1,778 1,444 1,163 1,110 1,068 1,037 1,010 1,003
624 beds . . . . . . . . . . 299 259 226 288 370 424 462 469 486
2549 beds . . . . . . . . . . 1,155 1,029 935 910 1,032 1,167 1,192 1,186 1,168
5099 beds . . . . . . . . . . 1,481 1,462 1,263 1,055 1,001 970 954 959 934
100199 beds . . . . . . . . 1,363 1,370 1,306 1,236 1,129 1,029 1,012 995 1,013
200299 beds . . . . . . . . 678 715 739 656 619 585 570 571 536
300399 beds . . . . . . . . 378 412 408 341 368 352 348 334 328
400499 beds . . . . . . . . 230 266 222 182 173 185 189 183 188
500 beds or more . . . . . . 291 317 285 247 244 273 272 277 273
Beds
All hospitals . . . . . . . . . . . . . . 1,465,828 1,364,516 1,213,327 983,628 946,997 941,995 920,829 914,513 902,202
Federal . . . . . . . . . . . . . . . 131,946 117,328 98,255 53,067 45,837 44,940 38,557 38,747 38,893
Nonfederal 1 . . . . . . . . . . . . . 1,333,882 1,247,188 1,115,072 930,561 901,160 897,055 882,272 875,766 863,309
Community 2 . . . . . . . . . . . 941,844 988,387 927,360 823,560 802,311 804,943 800,566 795,603 786,874
Nonprofit . . . . . . . . . . . 658,195 692,459 656,755 582,988 561,106 555,768 545,287 543,929 534,554
For profit . . . . . . . . . . . 73,495 87,033 101,377 109,883 113,510 124,652 135,008 134,643 135,909
State-local government . . . 210,154 208,895 169,228 130,689 127,695 124,523 120,271 117,031 116,411
624 beds . . . . . . . . . . 5,615 4,932 4,427 5,156 6,316 7,261 7,791 7,763 7,985
2549 beds . . . . . . . . . . 41,783 37,478 35,420 33,333 33,726 37,446 38,338 38,039 37,559
5099 beds . . . . . . . . . . 106,776 105,278 90,394 75,865 71,737 69,470 67,879 67,892 66,092
100199 beds . . . . . . . . 192,438 192,892 183,867 175,778 161,593 148,090 145,556 143,760 147,188
200299 beds . . . . . . . . 164,405 172,390 179,670 159,807 151,290 142,616 139,212 140,113 131,526
300399 beds . . . . . . . . 127,728 139,434 138,938 117,220 126,899 121,749 120,554 115,511 112,909
400499 beds . . . . . . . . 101,278 117,724 98,833 80,763 76,894 82,071 84,007 81,148 83,285
500 beds or more . . . . . . 201,821 218,259 195,811 175,638 173,856 196,240 197,229 201,377 200,330
Occupancy rate 3 Percent
All hospitals . . . . . . . . . . . . . . 76.7 77.7 69.5 66.1 69.3 66.6 65.2 64.7 64.8
Federal . . . . . . . . . . . . . . . 80.7 80.1 72.9 68.2 66.0 65.3 63.5 64.5 68.0
Nonfederal 1 . . . . . . . . . . . . . 76.3 77.4 69.2 65.9 69.5 66.6 65.3 64.7 64.6
Community 2 . . . . . . . . . . . 75.0 75.2 66.8 63.9 67.3 64.5 63.4 62.9 62.8
Nonprofit . . . . . . . . . . . 77.5 78.2 69.3 65.5 69.1 66.2 64.9 64.5 64.4
For profit . . . . . . . . . . . 65.9 65.2 52.8 55.9 59.6 57.1 56.8 56.2 56.6
State-local government . . . 70.4 71.1 65.3 63.2 66.7 64.4 63.8 62.9 62.9
624 beds . . . . . . . . . . 48.0 46.8 32.3 31.7 33.5 32.3 30.8 30.5 30.3
2549 beds . . . . . . . . . . 56.7 52.8 41.3 41.3 47.1 44.8 43.1 42.7 42.1
5099 beds . . . . . . . . . . 64.7 64.2 53.8 54.8 59.0 55.1 55.2 55.1 54.7
100199 beds . . . . . . . . 71.2 71.4 61.5 60.0 63.2 60.4 58.1 57.6 57.6
200299 beds . . . . . . . . 77.1 77.4 67.1 65.0 67.7 64.0 63.2 61.6 61.6
300399 beds . . . . . . . . 79.7 79.7 70.0 65.7 70.1 67.4 65.1 64.9 64.5
400499 beds . . . . . . . . 81.1 81.2 73.5 69.1 71.2 68.5 67.5 67.6 67.9
500 beds or more . . . . . . 80.9 82.1 77.3 72.2 75.9 73.0 72.6 72.1 72.3
1
The category of nonfederal hospitals comprises psychiatric hospitals, tuberculosis and other respiratory diseases hospitals, and long-term and short-term general and
other special hospitals. See Appendix II, Hospital.
2
Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities included in
the community hospitals category have changed over time. See Appendix II, Hospital.
3
Estimated percentage of staffed beds that are occupied. Occupancy rate is calculated as the average daily census (from the American Hospital Association) divided by
the number of hospital beds. See Appendix II, Occupancy rate.
SOURCE: American Hospital Association (AHA). Annual Survey of Hospitals. Hospital Statistics, 1976, 1981, 199192, 2002, 2014, 2015, and 2016 editions. Chicago,
IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1976, 1981, 199192, 2002, 2012, 2014, 2015, and 2016 editions by Health Forum, LLC, an
American Hospital Association Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
State 1980 1990 2000 2010 2013 2014 19801990 19902000 20002010 20102014
Beds per 1,000 resident population Average annual percent change 1
United States . . . . . . . . . . . . 4.5 3.7 2.9 2.6 2.5 2.5 1.9 2.4 1.1 1.0
Alabama . . . . . . . . . . . . . . 5.1 4.6 3.7 3.2 3.1 3.1 1.0 2.2 1.4 0.8
Alaska . . . . . . . . . . . . . . . 2.7 2.3 2.3 2.2 2.1 2.2 1.6 0.4
Arizona . . . . . . . . . . . . . . 3.6 2.7 2.1 2.0 2.0 2.0 2.8 2.5 0.5
Arkansas . . . . . . . . . . . . . 5.0 4.6 3.7 3.2 3.2 3.1 0.8 2.2 1.4 0.8
California . . . . . . . . . . . . . 3.6 2.7 2.1 1.9 1.8 1.8 2.8 2.5 1.0 1.3
Colorado . . . . . . . . . . . . . 4.2 3.2 2.2 2.0 2.0 2.0 2.7 3.7 0.9
Connecticut. . . . . . . . . . . . 3.5 2.9 2.3 2.3 2.2 2.2 1.9 2.3 1.1
Delaware . . . . . . . . . . . . . 3.6 3.0 2.3 2.4 2.2 2.2 1.8 2.6 0.4 2.2
District of Columbia . . . . . . . 7.3 7.6 5.8 5.7 5.6 5.4 0.4 2.7 0.2 1.3
Florida . . . . . . . . . . . . . . . 5.1 3.9 3.2 2.9 2.7 2.7 2.6 2.0 1.0 1.8
Georgia . . . . . . . . . . . . . . 4.6 4.0 2.9 2.6 2.5 2.4 1.4 3.2 1.1 2.0
Hawaii . . . . . . . . . . . . . . . 3.1 2.7 2.5 2.4 2.0 2.0 1.4 0.8 0.4 4.5
Idaho. . . . . . . . . . . . . . . . 3.7 3.2 2.7 2.2 2.1 2.0 1.4 1.7 2.0 2.4
Illinois . . . . . . . . . . . . . . . 5.1 4.0 3.0 2.6 2.5 2.5 2.4 2.8 1.4 1.0
Indiana. . . . . . . . . . . . . . . 4.5 3.9 3.2 2.8 2.6 2.6 1.4 2.0 1.3 1.8
Iowa . . . . . . . . . . . . . . . . 5.7 5.1 4.0 3.3 3.2 3.1 1.1 2.4 1.9 1.6
Kansas . . . . . . . . . . . . . . 5.8 4.8 4.0 3.5 3.5 3.5 1.9 1.8 1.3
Kentucky . . . . . . . . . . . . . 4.5 4.3 3.7 3.3 3.2 3.2 0.5 1.5 1.1 0.8
Louisiana . . . . . . . . . . . . . 4.8 4.6 3.9 3.4 3.4 3.2 0.4 1.6 1.4 1.5
Maine . . . . . . . . . . . . . . . 4.7 3.7 2.9 2.7 2.6 2.5 2.4 2.4 0.7 1.9
Maryland . . . . . . . . . . . . . 3.6 2.8 2.1 2.0 2.1 2.0 2.5 2.8 0.5
Massachusetts . . . . . . . . . . 4.4 3.6 2.6 2.4 2.5 2.4 2.0 3.2 0.8
Michigan . . . . . . . . . . . . . 4.4 3.7 2.6 2.6 2.5 2.5 1.7 3.5 1.0
Minnesota . . . . . . . . . . . . . 5.7 4.4 3.4 2.9 2.7 2.7 2.6 2.5 1.6 1.8
Mississippi . . . . . . . . . . . . 5.3 5.0 4.8 4.4 4.3 4.2 0.6 0.4 0.9 1.2
Missouri . . . . . . . . . . . . . . 5.7 4.8 3.6 3.1 3.1 3.1 1.7 2.8 1.5
Montana . . . . . . . . . . . . . . 5.9 5.8 4.7 3.8 3.7 3.6 0.2 2.1 2.1 1.3
Nebraska . . . . . . . . . . . . . 6.0 5.5 4.8 4.0 3.6 3.5 0.9 1.4 1.8 3.3
Nevada . . . . . . . . . . . . . . 4.2 2.8 1.9 2.0 2.0 2.0 4.0 3.8 0.5
New Hampshire . . . . . . . . . 3.9 3.1 2.3 2.2 2.1 2.1 2.3 2.9 0.4 1.2
New Jersey . . . . . . . . . . . . 4.2 3.7 3.0 2.4 2.4 2.3 1.3 2.1 2.2 1.1
New Mexico . . . . . . . . . . . 3.1 2.8 1.9 2.0 1.8 1.8 1.0 3.8 0.5 2.6
New York . . . . . . . . . . . . . 4.5 4.1 3.5 3.0 2.9 2.8 0.9 1.6 1.5 1.7
North Carolina . . . . . . . . . . 4.2 3.3 2.9 2.4 2.3 2.2 2.4 1.3 1.9 2.2
North Dakota . . . . . . . . . . . 7.4 7.0 6.0 5.1 4.0 4.3 0.6 1.5 1.6 4.2
Ohio . . . . . . . . . . . . . . . . 4.7 4.0 3.0 3.0 2.9 2.9 1.6 2.8 0.8
Oklahoma . . . . . . . . . . . . . 4.6 4.0 3.2 3.0 3.0 2.9 1.4 2.2 0.6 0.8
Oregon . . . . . . . . . . . . . . 3.5 2.8 1.9 1.7 1.7 1.7 2.2 3.8 1.1
Pennsylvania . . . . . . . . . . . 4.8 4.4 3.4 3.2 3.1 3.0 0.9 2.5 0.6 1.6
Rhode Island . . . . . . . . . . . 3.8 3.2 2.3 2.3 2.1 2.1 1.7 3.2 2.2
South Carolina . . . . . . . . . . 3.9 3.3 2.9 2.7 2.7 2.5 1.7 1.3 0.7 1.9
South Dakota . . . . . . . . . . . 5.5 6.1 5.7 5.0 4.9 4.8 1.0 0.7 1.3 1.0
Tennessee . . . . . . . . . . . . 5.5 4.8 3.6 3.3 3.1 3.1 1.4 2.8 0.9 1.6
Texas . . . . . . . . . . . . . . . 4.7 3.5 2.7 2.4 2.3 2.3 2.9 2.6 1.2 1.1
Utah . . . . . . . . . . . . . . . . 3.1 2.6 1.9 1.8 1.8 1.8 1.7 3.1 0.5
Vermont . . . . . . . . . . . . . . 4.4 3.0 2.7 2.1 1.9 1.9 3.8 1.0 2.5 2.5
Virginia . . . . . . . . . . . . . . 4.1 3.3 2.4 2.2 2.2 2.2 2.1 3.1 0.9
Washington . . . . . . . . . . . . 3.1 2.5 1.9 1.7 1.7 1.7 2.1 2.7 1.1
West Virginia . . . . . . . . . . . 5.5 4.7 4.4 4.0 3.8 3.7 1.6 0.7 0.9 1.9
Wisconsin . . . . . . . . . . . . . 4.9 3.8 2.9 2.4 2.2 2.2 2.5 2.7 1.9 2.2
Wyoming . . . . . . . . . . . . . 3.6 4.8 3.9 3.6 3.3 3.1 2.9 2.1 0.8 3.7
Quantity zero.
1
See Appendix II, Average annual rate of change (percent change).
NOTES: Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities
included in the community hospitals category have changed over time. See Appendix II, Hospital. See Health, United States, 2013, Table 108, for 1970 hospital data.
SOURCE: American Hospital Association (AHA). Annual Survey of Hospitals. Hospital Statistics, 1981, 199192, 2002, 2012, 2014, 2015, and 2016 editions. Chicago,
IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1981, 199192, 2002, 2012, 2014, 2015, and 2016 by Health Forum, LLC, an American Hospital
Association Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
State 1980 1990 2000 2010 2014 19801990 19902000 20002010 20102014
Occupancy rate 1 Average annual percent change 2
United States . . . . . . . . . . . . 75 67 64 65 63 1.1 0.5 0.2 0.8
Quantity zero.
1
Estimated percent of staffed beds that are occupied. Occupancy rate is calculated as the average daily census (inpatient days divided by 365) divided by the number
2
See Appendix II, Average annual rate of change (percent change).
NOTES: Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities
included in the community hospitals category have changed over time. See Appendix II, Hospital. See Health, United States, 2013, Table 109, for 1970 hospital data.
SOURCE: American Hospital Association (AHA). Annual Survey of Hospitals. Hospital Statistics, 1981, 199192, 2002, 2012, 2014, 2015, and 2016 editions. Chicago,
IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1981, 199192, 2002, 2012, 2014, 2015, and 2016 by Health Forum, LLC, an American Hospital
Association Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
Number
United States . . . . . . . . . . . . 16,389 16,886 15,643 15,656 1,751,302 1,795,388 1,693,943 1,694,777
Alabama . . . . . . . . . . . . . . 221 225 226 227 23,353 25,248 26,388 26,506
Alaska . . . . . . . . . . . . . . . 15 15 18 18 814 821 693 693
Arizona . . . . . . . . . . . . . . 152 150 147 145 16,162 17,458 16,605 16,523
Arkansas . . . . . . . . . . . . . 256 255 229 228 29,952 25,715 24,558 24,463
California . . . . . . . . . . . . . 1,382 1,369 1,217 1,213 140,203 131,762 119,866 119,046
Colorado . . . . . . . . . . . . . 219 225 214 217 19,912 20,240 20,431 20,560
Connecticut. . . . . . . . . . . . 267 259 229 229 32,827 32,433 27,673 27,608
Delaware . . . . . . . . . . . . . 42 43 46 45 4,739 4,906 4,876 4,791
District of Columbia . . . . . . . 19 20 19 19 3,206 3,078 2,766 2,766
Florida . . . . . . . . . . . . . . . 627 732 689 689 72,656 83,365 83,545 83,668
Georgia . . . . . . . . . . . . . . 352 363 357 358 38,097 39,817 39,975 39,857
Hawaii . . . . . . . . . . . . . . . 34 45 46 46 2,513 4,006 4,213 4,313
Idaho. . . . . . . . . . . . . . . . 76 84 78 79 5,747 6,181 5,951 5,977
Illinois . . . . . . . . . . . . . . . 827 869 761 762 103,230 110,766 98,348 98,489
Indiana. . . . . . . . . . . . . . . 556 564 528 541 59,538 56,762 59,555 61,048
Iowa . . . . . . . . . . . . . . . . 419 467 443 442 39,959 37,034 31,950 31,843
Kansas . . . . . . . . . . . . . . 429 392 345 344 30,016 27,067 25,730 25,756
Kentucky . . . . . . . . . . . . . 288 307 287 289 23,221 25,341 26,300 27,060
Louisiana . . . . . . . . . . . . . 337 337 280 279 37,769 39,430 35,066 34,537
Maine . . . . . . . . . . . . . . . 132 126 105 103 9,243 8,248 6,953 6,904
Maryland . . . . . . . . . . . . . 218 255 228 228 28,394 31,495 28,115 28,013
Massachusetts . . . . . . . . . . 550 526 416 413 54,532 56,030 48,320 47,990
Michigan . . . . . . . . . . . . . 432 439 433 437 49,473 50,696 46,521 46,669
Minnesota . . . . . . . . . . . . . 432 433 377 377 43,865 42,149 30,319 29,934
Mississippi . . . . . . . . . . . . 183 190 205 204 16,059 17,068 18,434 18,426
Missouri . . . . . . . . . . . . . . 546 551 512 512 52,679 54,829 55,273 55,245
Montana . . . . . . . . . . . . . . 100 104 83 80 7,210 7,667 6,732 6,693
Nebraska . . . . . . . . . . . . . 231 236 219 217 18,169 17,877 16,005 15,961
Nevada . . . . . . . . . . . . . . 42 51 52 54 3,998 5,547 6,040 6,256
New Hampshire . . . . . . . . . 74 83 76 76 7,412 7,837 7,501 7,525
New Jersey . . . . . . . . . . . . 300 361 361 365 43,967 52,195 52,051 52,538
New Mexico . . . . . . . . . . . 83 80 71 73 6,969 7,289 6,869 7,070
New York . . . . . . . . . . . . . 624 665 628 626 107,750 120,514 117,131 116,666
North Carolina . . . . . . . . . . 391 410 422 423 38,322 41,376 45,088 45,221
North Dakota . . . . . . . . . . . 87 88 81 80 7,125 6,954 6,131 6,009
Ohio . . . . . . . . . . . . . . . . 943 1,009 954 959 106,884 105,038 90,653 90,667
Oklahoma . . . . . . . . . . . . . 405 392 309 305 33,918 33,903 28,962 28,580
Oregon . . . . . . . . . . . . . . 161 150 137 137 13,885 13,500 12,210 12,274
Pennsylvania . . . . . . . . . . . 726 770 699 699 92,625 95,063 88,236 88,133
Rhode Island . . . . . . . . . . . 94 99 84 84 9,612 10,271 8,720 8,720
South Carolina . . . . . . . . . . 166 178 188 187 16,682 18,102 19,631 19,758
South Dakota . . . . . . . . . . . 114 114 111 111 8,296 7,844 6,945 6,893
Tennessee . . . . . . . . . . . . 322 349 321 319 37,074 38,593 37,268 36,719
Texas . . . . . . . . . . . . . . . 1,266 1,215 1,212 1,222 123,056 125,052 136,000 137,396
Utah . . . . . . . . . . . . . . . . 91 93 99 100 7,101 7,651 8,577 8,639
Vermont . . . . . . . . . . . . . . 23 44 37 37 1,862 3,743 3,174 3,174
Virginia . . . . . . . . . . . . . . 271 278 288 286 30,070 30,595 32,497 32,447
Washington . . . . . . . . . . . . 285 277 221 220 28,464 25,905 21,286 21,145
West Virginia . . . . . . . . . . . 129 139 127 126 10,903 11,413 10,888 10,858
Wisconsin . . . . . . . . . . . . . 413 420 389 388 48,754 46,395 33,959 33,800
Wyoming . . . . . . . . . . . . . 37 40 39 38 3,035 3,119 2,965 2,950
See footnotes at end of table.
Number
United States . . . . . . . . . . . . 1,479,550 1,480,076 1,368,667 1,360,970 84.5 82.4 80.8 80.3
Alabama . . . . . . . . . . . . . . 21,691 23,089 22,731 22,721 92.9 91.4 86.1 85.7
Alaska . . . . . . . . . . . . . . . 634 595 612 626 77.9 72.5 88.3 90.3
Arizona . . . . . . . . . . . . . . 12,382 13,253 11,428 11,588 76.6 75.9 68.8 70.1
Arkansas . . . . . . . . . . . . . 20,823 19,317 17,688 17,655 69.5 75.1 72.0 72.2
California . . . . . . . . . . . . . 109,805 106,460 102,245 102,674 78.3 80.8 85.3 86.2
Colorado . . . . . . . . . . . . . 17,055 17,045 16,309 16,290 85.7 84.2 79.8 79.2
Connecticut. . . . . . . . . . . . 29,948 29,657 24,250 24,018 91.2 91.4 87.6 87.0
Delaware . . . . . . . . . . . . . 3,819 3,900 4,314 4,253 80.6 79.5 88.5 88.8
District of Columbia . . . . . . . 2,576 2,858 2,539 2,540 80.3 92.9 91.8 91.8
Florida . . . . . . . . . . . . . . . 61,845 69,050 73,487 73,492 85.1 82.8 88.0 87.8
Georgia . . . . . . . . . . . . . . 35,933 36,559 33,930 33,399 94.3 91.8 84.9 83.8
Hawaii . . . . . . . . . . . . . . . 2,413 3,558 3,663 3,568 96.0 88.8 86.9 82.7
Idaho. . . . . . . . . . . . . . . . 4,697 4,640 3,841 3,881 81.7 75.1 64.5 64.9
Illinois . . . . . . . . . . . . . . . 83,696 83,604 72,563 71,952 81.1 75.5 73.8 73.1
Indiana. . . . . . . . . . . . . . . 44,328 42,328 38,893 39,267 74.5 74.6 65.3 64.3
Iowa . . . . . . . . . . . . . . . . 27,506 29,204 24,859 24,585 68.8 78.9 77.8 77.2
Kansas . . . . . . . . . . . . . . 25,140 22,230 18,337 18,204 83.8 82.1 71.3 70.7
Kentucky . . . . . . . . . . . . . 20,696 22,730 23,008 23,453 89.1 89.7 87.5 86.7
Louisiana . . . . . . . . . . . . . 32,493 30,735 25,854 25,722 86.0 77.9 73.7 74.5
Maine . . . . . . . . . . . . . . . 8,587 7,298 6,239 6,199 92.9 88.5 89.7 89.8
Maryland . . . . . . . . . . . . . 24,716 25,629 24,430 24,572 87.0 81.4 86.9 87.7
Massachusetts . . . . . . . . . . 49,765 49,805 41,255 40,794 91.3 88.9 85.4 85.0
Michigan . . . . . . . . . . . . . 43,271 42,615 39,374 39,275 87.5 84.1 84.6 84.2
Minnesota . . . . . . . . . . . . . 41,163 38,813 26,695 25,725 93.8 92.1 88.0 85.9
Mississippi . . . . . . . . . . . . 15,247 15,815 16,129 16,026 94.9 92.7 87.5 87.0
Missouri . . . . . . . . . . . . . . 39,891 38,586 38,326 38,418 75.7 70.4 69.3 69.5
Montana . . . . . . . . . . . . . . 6,415 5,973 4,619 4,466 89.0 77.9 68.6 66.7
Nebraska . . . . . . . . . . . . . 16,166 14,989 12,043 11,938 89.0 83.8 75.2 74.8
Nevada . . . . . . . . . . . . . . 3,645 3,657 4,821 4,827 91.2 65.9 79.8 77.2
New Hampshire . . . . . . . . . 6,877 7,158 6,767 6,706 92.8 91.3 90.2 89.1
New Jersey . . . . . . . . . . . . 40,397 45,837 45,185 44,998 91.9 87.8 86.8 85.6
New Mexico . . . . . . . . . . . 6,051 6,503 5,439 5,502 86.8 89.2 79.2 77.8
New York . . . . . . . . . . . . . 103,409 112,957 105,390 104,684 96.0 93.7 90.0 89.7
North Carolina . . . . . . . . . . 35,511 36,658 37,058 36,612 92.7 88.6 82.2 81.0
North Dakota . . . . . . . . . . . 6,868 6,343 5,664 5,571 96.4 91.2 92.4 92.7
Ohio . . . . . . . . . . . . . . . . 79,026 81,946 76,325 75,523 73.9 78.0 84.2 83.3
Oklahoma . . . . . . . . . . . . . 26,377 23,833 19,108 18,854 77.8 70.3 66.0 66.0
Oregon . . . . . . . . . . . . . . 11,673 9,990 7,343 7,379 84.1 74.0 60.1 60.1
Pennsylvania . . . . . . . . . . . 84,843 83,880 79,598 78,822 91.6 88.2 90.2 89.4
Rhode Island . . . . . . . . . . . 8,823 9,041 8,011 7,966 91.8 88.0 91.9 91.4
South Carolina . . . . . . . . . . 14,568 15,739 16,773 16,830 87.3 86.9 85.4 85.2
South Dakota . . . . . . . . . . . 7,926 7,059 6,381 6,301 95.5 90.0 91.9 91.4
Tennessee . . . . . . . . . . . . 33,929 34,714 28,897 28,246 91.5 89.9 77.5 76.9
Texas . . . . . . . . . . . . . . . 89,354 85,275 93,170 93,316 72.6 68.2 68.5 67.9
Utah . . . . . . . . . . . . . . . . 5,832 5,703 5,515 5,518 82.1 74.5 64.3 63.9
Vermont . . . . . . . . . . . . . . 1,792 3,349 2,686 2,628 96.2 89.5 84.6 82.8
Virginia . . . . . . . . . . . . . . 28,119 27,091 28,486 27,874 93.5 88.5 87.7 85.9
Washington . . . . . . . . . . . . 24,954 21,158 17,005 16,969 87.7 81.7 79.9 80.3
West Virginia . . . . . . . . . . . 10,216 10,334 9,535 9,471 93.7 90.5 87.6 87.2
Wisconsin . . . . . . . . . . . . . 43,998 38,911 27,485 26,804 90.2 83.9 80.9 79.3
Wyoming . . . . . . . . . . . . . 2,661 2,605 2,364 2,268 87.7 83.5 79.7 76.9
1
Percentage of beds occupied (number of nursing home residents per 100 nursing home beds). See Appendix II, Occupancy rate.
NOTES: Annual numbers of nursing homes, beds, and residents are based on the Centers for Medicare & Medicaid Services' reporting cycle. Starting with 2013 data, a
new editing rule was used for number of beds. For the U.S., the number of beds decreased by less than 1%. For most states, this caused little or no change in the data.
The change in the number of beds also caused a change in some occupancy rates. Because of the methodology change, trends should be interpreted with caution.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Cowles CM ed., 2015 Nursing Home Statistical Yearbook. Anacortes, WA: Cowles Research Group, 2016 and previous editions; and Cowles Research
Group, unpublished data. Based on data from the Centers for Medicare & Medicaid Services' Quality Improvement Evaluation System (QIES) and its predecessor, the
Online Survey Certification and Reporting Database (OSCAR). See Appendix I, Quality Improvement Evaluation System (QIES).
national health expenditures 1960 1970 1975 1980 1990 2000 2009 2014 2015
Amount, in billions
Gross domestic product (GDP) . . . . . . . . $543 $1,076 $1,689 $2,863 $5,980 $10,285 $14,419 $17,393 $18,037
Deflator (2009 = 100.0)
Price deflator for GDP 1 . . . . . . . . . . . . 17.5 22.8 31.4 44.5 66.8 81.9 100.0 108.8 110.0
Amount, in billions
National health expenditures . . . . . . . . . $27.2 $74.6 $133.3 $255.3 $721.4 $1,369.7 $2,494.7 $3,029.3 $3,205.6
Health consumption expenditures . . . . . 24.7 67.0 121.1 235.5 674.1 1,286.4 2,355.7 2,878.4 3,050.8
Personal health care . . . . . . . . . . . 23.3 63.1 113.2 217.0 615.3 1,162.0 2,114.2 2,562.8 2,717.2
Administration and net cost of
private health insurance . . . . . . . . 1.1 2.6 4.9 12.1 38.7 81.3 167.4 236.6 252.7
Public health . . . . . . . . . . . . . . . 0.4 1.4 3.0 6.4 20.0 43.0 74.1 79.0 80.9
Investment 2 . . . . . . . . . . . . . . . . . 2.5 7.5 12.2 19.9 47.3 83.3 139.0 150.9 154.7
Deflator (2009 = 100.0)
Chain-weighted national health expenditure
deflator 1 . . . . . . . . . . . . . . . . . . . --- --- --- --- --- --- 100.0 110.2 111.5
Per capita amount, in dollars
National health expenditures . . . . . . . . . $146 $355 $605 $1,108 $2,843 $4,857 $8,141 $9,515 $9,990
Health consumption expenditures . . . . . 133 319 550 1,022 2,657 4,562 7,687 9,041 9,508
Personal health care . . . . . . . . . . . 125 300 514 942 2,425 4,121 6,899 8,050 8,468
Percent
National health expenditures as
percent of GDP . . . . . . . . . . . . . . . . 5.0 6.9 7.9 8.9 12.1 13.3 17.3 17.4 17.8
Percent distribution
National health expenditures . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Health consumption expenditures . . . . . 90.8 89.9 90.9 92.2 93.4 93.9 94.4 95.0 95.2
Personal health care . . . . . . . . . . . 85.5 84.6 84.9 85.0 85.3 84.8 84.7 84.6 84.8
Administration and net cost of
private health insurance . . . . . . . . 3.9 3.5 3.7 4.7 5.4 5.9 6.7 7.8 7.9
Public health . . . . . . . . . . . . . . . 1.4 1.8 2.2 2.5 2.8 3.1 3.0 2.6 2.5
Investment 2 . . . . . . . . . . . . . . . . . 9.2 10.1 9.1 7.8 6.6 6.1 5.6 5.0 4.8
Average annual percent change from previous year shown 3
GDP . . . . . . . . . . . . . . . . . . . . . . ... 7.1 9.4 11.1 7.6 5.6 3.8 3.8 3.7
National health expenditures . . . . . . . . . ... 10.6 12.3 13.9 10.9 6.6 6.9 4.0 5.8
Health consumption expenditures . . . . . ... 10.5 12.6 14.2 11.1 6.7 7.0 4.1 6.0
Personal health care . . . . . . . . . . . ... 10.5 12.4 13.9 11.0 6.6 6.9 3.9 6.0
Administration and net cost of
private health insurance . . . . . . . . ... 9.4 13.3 19.6 12.4 7.7 8.4 7.2 6.8
Public health . . . . . . . . . . . . . . . ... 13.8 17.0 16.8 12.0 8.0 6.2 1.3 2.4
Investment 2 . . . . . . . . . . . . . . . . . ... 11.6 10.1 10.3 9.1 5.8 5.8 1.7 2.6
National health expenditures, per capita . . . ... 9.3 11.3 12.9 9.9 5.5 5.9 3.2 5.0
Health consumption expenditures . . . . . ... 9.1 11.5 13.2 10.0 5.6 6.0 3.3 5.2
Personal health care . . . . . . . . . . . ... 9.1 11.4 12.9 9.9 5.4 5.9 3.1 5.2
Administration and net cost of
private health insurance . . . . . . . . ... 8.0 11.1 18.8 11.4 6.5 7.4 6.4 5.9
Public health . . . . . . . . . . . . . . . ... 11.6 16.7 16.6 10.9 6.8 5.2 0.5 1.6
Investment 2 . . . . . . . . . . . . . . . . . ... 10.7 8.8 9.4 8.1 4.7 4.9 0.9 1.7
See footnotes at end of table.
1
Year 2009 = 100.0. For more information on the detailed price series recommended for deflating each category of spending, see the National Health Expenditure
Accounts Methodology Paper, 2015 and NHE Deflator Methodology paper. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html.
2
Investment consists of research and structures and equipment.
3
See Appendix II, Average annual rate of change (percent change).
NOTES: Dollar amounts shown are in current dollars. See Appendix II, Gross domestic product (GDP); Health expenditures, national. Percents are calculated using
unrounded data. Estimates may not add to totals because of rounding. Census resident-based population less armed forces overseas and population of outlying areas
used to calculate per capita. For more information on NHE categories, sources, and methods, see the National Health Expenditure Accounts Methodology Paper, 2015.
See Appendix I, National Health Expenditure Accounts (NHEA). Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
expenditures aggregate. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html,
accessed on January 5, 2017. U.S. Department of Commerce Bureau of Economic Analysis, National Economic Accounts, National Income and Product Accounts,
Table 1.1.4, accessed on January 5, 2017. Available from: http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1. See Appendix I, National Health Expenditure
Accounts (NHEA); National Income and Product Accounts (NIPA).
Type of national health expenditure 1960 1970 1975 1980 1990 2000 2009 2014 2015
Amount, in billions
National health expenditures . . . . . . . . . . . . . $27.2 $74.6 $133.3 $255.3 $721.4 $1,369.7 $2,494.7 $3,029.3 $3,205.6
Health consumption expenditures . . . . . . . . . 24.7 67.0 121.1 235.5 674.1 1,286.4 2,355.7 2,878.4 3,050.8
Personal health care . . . . . . . . . . . . . . . 23.3 63.1 113.2 217.0 615.3 1,162.0 2,114.2 2,562.8 2,717.2
Hospital care . . . . . . . . . . . . . . . . . 9.0 27.2 51.2 100.5 250.4 415.5 779.7 981.0 1036.1
Professional services . . . . . . . . . . . . . 7.9 19.8 34.7 64.5 207.3 387.5 668.2 792.8 840.2
Physician and clinical services . . . . . . . 5.6 14.3 25.3 47.7 158.4 288.7 498.7 597.1 634.9
Other professional services. . . . . . . . . 0.4 0.7 1.3 3.5 17.3 36.6 67.2 82.8 87.7
Dental services . . . . . . . . . . . . . . . 2.0 4.7 8.0 13.3 31.6 62.1 102.3 112.8 117.5
Other health, residential, and personal care . 0.4 1.3 2.9 8.4 23.8 63.9 123.4 151.5 163.3
Home health care 1 . . . . . . . . . . . . . . 0.1 0.2 0.6 2.4 12.5 32.3 67.3 83.6 88.8
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . 0.8 4.0 8.0 15.3 44.7 85.0 134.9 152.6 156.8
Retail outlet sales of medical products . . . . 5.0 10.6 15.8 25.9 76.5 177.8 340.8 401.4 432.0
Prescription drugs . . . . . . . . . . . . . 2.7 5.5 8.1 12.0 40.3 121.0 252.7 297.9 324.6
Durable medical equipment . . . . . . . . 0.7 1.7 2.8 4.1 13.8 25.2 37.8 46.6 48.5
Other nondurable medical products . . . . 1.6 3.3 4.9 9.8 22.4 31.6 50.3 56.9 59.0
Government administration 2 . . . . . . . . . 0.1 0.7 1.5 2.8 7.2 17.1 29.6 41.2 42.6
Net cost of health insurance 3 . . . . . . . . . 1.0 1.9 3.4 9.3 31.6 64.2 137.9 195.3 210.1
Government public health activities 4 . . . . . 0.4 1.4 3.0 6.4 20.0 43.1 74.1 79.0 80.9
Investment . . . . . . . . . . . . . . . . . . . . . 2.5 7.5 12.2 19.9 47.3 83.3 139.0 150.9 154.7
Research 5 . . . . . . . . . . . . . . . . . . . . 0.7 2.0 3.4 5.4 12.7 25.5 45.4 45.9 46.7
Structures and equipment . . . . . . . . . . . . 1.8 5.6 8.8 14.4 34.6 57.8 93.6 105.0 108.0
Average annual percent change from previous year shown 6
National health expenditures . . . . . . . . . . . . . ... 10.6 12.3 13.9 10.9 6.6 6.9 4.0 5.8
Health consumption expenditures . . . . . . . . . ... 10.5 12.6 14.2 11.1 6.7 7.0 4.1 6.0
Personal health care . . . . . . . . . . . . . . . ... 10.5 12.4 13.9 11.0 6.6 6.9 3.9 6.0
Hospital care . . . . . . . . . . . . . . . . . ... 11.7 13.5 14.4 9.6 5.2 7.2 4.7 5.6
Professional services . . . . . . . . . . . . . ... 9.6 11.9 13.2 12.4 6.5 6.2 3.5 6.0
Physician and clinical services . . . . . . . ... 9.9 12.0 13.5 12.7 6.2 6.3 3.7 6.3
Other professional services. . . . . . . . . ... 6.3 13.0 21.1 17.4 7.8 7.0 4.3 5.9
Dental services . . . . . . . . . . . . . . . ... 9.0 11.2 10.7 9.0 7.0 5.7 2.0 4.2
Other health, residential, and personal care . ... 11.5 17.2 23.9 11.0 10.4 7.6 4.2 7.8
Home health care 1 . . . . . . . . . . . . . . ... 14.5 23.2 30.7 18.1 9.9 8.5 4.4 6.3
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . ... 17.4 14.7 13.7 11.4 6.6 5.3 2.5 2.7
Retail outlet sales of medical products . . . . ... 7.7 8.4 10.4 11.4 8.8 7.5 3.3 7.6
Prescription drugs . . . . . . . . . . . . . ... 7.5 7.9 8.4 12.8 11.6 8.5 3.3 9.0
Durable medical equipment . . . . . . . . ... 9.0 9.9 7.7 13.0 6.2 4.6 4.3 3.9
Other nondurable medical products . . . . ... 7.4 8.3 14.6 8.6 3.5 5.3 2.5 3.7
Government administration 2 . . . . . . . . . . . ... 30.0 15.1 13.2 10.0 9.0 6.3 6.9 3.2
Net cost of health insurance 3 . . . . . . . . . . ... 6.4 12.6 22.0 13.0 7.4 8.9 7.2 7.6
Government public health activities 4 . . . . . . ... 13.8 17.0 16.8 12.0 8.0 6.2 1.3 2.4
Investment . . . . . . . . . . . . . . . . . . . . . ... 11.6 10.1 10.3 9.1 5.8 5.8 1.7 2.6
Research 5 . . . . . . . . . . . . . . . . . . . . ... 10.9 11.5 10.0 8.9 7.2 6.6 0.2 1.8
Structures and equipment . . . . . . . . . . . . ... 11.9 9.6 10.4 9.2 5.3 5.5 2.3 2.9
Percent distribution
National health expenditures . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Health consumption expenditures . . . . . . . . . 90.8 89.9 90.9 92.2 93.4 93.9 94.4 95.0 95.2
Personal health care . . . . . . . . . . . . . . . 85.5 84.6 84.9 85.0 85.3 84.8 84.7 84.6 84.8
Hospital care . . . . . . . . . . . . . . . . . 33.0 36.4 38.4 39.4 34.7 30.3 31.3 32.4 32.3
Professional services . . . . . . . . . . . . . 29.1 26.5 26.0 25.3 28.7 28.3 26.8 26.2 26.2
Physician and clinical services . . . . . . . 20.4 19.2 19.0 18.7 22.0 21.1 20.0 19.7 19.8
Other professional services. . . . . . . . . 1.4 1.0 1.0 1.4 2.4 2.7 2.7 2.7 2.7
Dental services . . . . . . . . . . . . . . . 7.3 6.3 6.0 5.2 4.4 4.5 4.1 3.7 3.7
Other health, residential, and personal care . 1.6 1.7 2.2 3.3 3.3 4.7 4.9 5.0 5.1
Home health care 1 . . . . . . . . . . . . . . 0.2 0.3 0.5 0.9 1.7 2.4 2.7 2.8 2.8
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . 3.0 5.4 6.0 6.0 6.2 6.2 5.4 5.0 4.9
Retail outlet sales of medical products . . . . 18.5 14.2 11.9 10.1 10.6 13.0 13.7 13.3 13.5
Prescription drugs . . . . . . . . . . . . . 9.8 7.4 6.0 4.7 5.6 8.8 10.1 9.8 10.1
Durable medical equipment . . . . . . . . 2.7 2.3 2.1 1.6 1.9 1.8 1.5 1.5 1.5
Other nondurable medical products . . . . 6.0 4.5 3.7 3.8 3.1 2.3 2.0 1.9 1.8
Government administration 2 . . . . . . . . . . . 0.2 1.0 1.1 1.1 1.0 1.2 1.2 1.4 1.3
Net cost of health insurance 3 . . . . . . . . . . 3.7 2.5 2.6 3.6 4.4 4.7 5.5 6.4 6.6
Government public health activities 4 . . . . . . 1.4 1.8 2.2 2.5 2.8 3.1 3.0 2.6 2.5
Investment . . . . . . . . . . . . . . . . . . . . . 9.2 10.1 9.1 7.8 6.6 6.1 5.6 5.0 4.8
Research 5 . . . . . . . . . . . . . . . . . . . . 2.6 2.6 2.5 2.1 1.8 1.9 1.8 1.5 1.5
Structures and equipment . . . . . . . . . . . . 6.7 7.5 6.6 5.7 4.8 4.2 3.8 3.5 3.4
See footnotes at end of table.
Type of national health expenditure 1960 1970 1975 1980 1990 2000 2009 2014 2015
Percent distribution
Personal health care . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Hospital care . . . . . . . . . . . . . . . . . 38.6 43.1 45.3 46.3 40.7 35.8 36.9 38.3 38.1
Professional services . . . . . . . . . . . . . 34.1 31.3 30.6 29.7 33.7 33.3 31.6 30.9 30.9
Physician and clinical services . . . . . . . 23.9 22.7 22.4 22.0 25.7 24.8 23.6 23.3 23.4
Other professional services. . . . . . . . . 1.7 1.2 1.2 1.6 2.8 3.2 3.2 3.2 3.2
Dental services . . . . . . . . . . . . . . . 8.5 7.5 7.1 6.1 5.1 5.3 4.8 4.4 4.3
Other health, residential, and personal care . 1.9 2.1 2.5 3.9 3.9 5.5 5.8 5.9 6.0
Home health care 1 . . . . . . . . . . . . . . 0.2 0.3 0.5 1.1 2.0 2.8 3.2 3.3 3.3
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . 3.5 6.4 7.1 7.0 7.3 7.3 6.4 6.0 5.8
Retail outlet sales of medical products . . . . 21.7 16.8 14.0 11.9 12.4 15.3 16.1 15.7 15.9
Prescription drugs . . . . . . . . . . . . . 11.5 8.7 7.1 5.6 6.5 10.4 12.0 11.6 11.9
Durable medical equipment . . . . . . . . 3.2 2.8 2.5 1.9 2.2 2.2 1.8 1.8 1.8
Other nondurable medical products . . . . 7.0 5.3 4.4 4.5 3.6 2.7 2.4 2.2 2.2
1
Includes expenditures for care in freestanding facilities only. Additional services of this type are provided in hospital-based facilities and are considered hospital care.
2
Includes all administrative costs (federal and state and local employees' salaries; contracted employees, including fiscal intermediaries; rent and building costs;
computer systems and programs; other materials and supplies; and other miscellaneous expenses) associated with insuring individuals enrolled in the following
health insurance programs: Medicare, Medicaid, Children's Health Insurance Program, Department of Defense, Department of Veterans Affairs, Indian Health Service,
workers' compensation, maternal and child health, vocational rehabilitation, Substance Abuse and Mental Health Services Administration, and other federal programs.
3
Net cost of health insurance is calculated as the difference between calendar year incurred premiums earned and benefits incurred for private health insurance. This
includes administrative costs, and in some cases additions to reserves, rate credits and dividends, premium taxes, and net underwriting gains or losses. Also included
in this category is the difference between premiums earned and benefits incurred for the private health insurance companie that insure the enrollees of the following
programs: Medicare, Medicaid, Children's Health Insurance Program, and workers' compensation (health portion only).
4
Includes health care services delivered by government public health agencies.
5
Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded. These are
included in the expenditure class in which the product falls because such expenditures are covered by the payment received for that product.
6
See Appendix II, Average annual rate of change (percent change).
NOTES: Percents and average annual percent change are calculated using unrounded data. For more information on NHE categories, sources, and methods, see the
National Health Expenditure Accounts Methodology Paper, 2015. See Appendix I, National Health Expenditure Accounts (NHEA). Data have been revised and differ
from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
expenditures. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html,
accessed on January 5, 2017. See Appendix I, National Health Expenditure Accounts (NHEA).
Amount
Per capita . . . . . . . . . . . . . . . . . . . . . . . $125 $300 $514 $942 $2,425 $4,121 $6,899 $8,050 $8,468
Amount, in billions
All personal health care expenditures 1 . . . . . . . . $23.3 $63.1 $113.2 $217.0 $615.3 $1,162.0 $2,114.2 $2,562.8 $2,717.2
Out-of-pocket payments . . . . . . . . . . . . . . 12.9 25.0 37.3 58.1 137.9 199.0 293.1 329.7 338.1
Health insurance . . . . . . . . . . . . . . . . . . 6.6 29.7 62.1 132.1 402.9 844.2 1,636.7 2,009.4 2,151.2
Private health insurance . . . . . . . . . . . . . 5.0 14.1 27.7 61.5 204.8 406.1 734.4 875.2 944.7
Medicare . . . . . . . . . . . . . . . . . . . . . ... 7.3 15.6 36.3 107.3 216.3 470.3 580.6 605.0
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 5.0 12.8 24.7 69.7 186.9 346.2 446.7 486.5
Federal . . . . . . . . . . . . . . . . . . . . ... 2.7 7.0 13.7 40.3 109.3 230.6 274.4 306.2
State and local . . . . . . . . . . . . . . . . ... 2.3 5.8 11.0 29.4 77.6 115.6 172.3 180.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 2.5 9.5 10.8 12.0
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 1.8 6.7 7.6 9.0
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.8 2.8 3.3 3.0
Other health insurance programs 3 . . . . . . . . 1.7 3.3 5.9 9.6 21.2 32.3 76.2 96.2 103.0
Other third-party payers and programs 4 . . . . . . 3.7 8.5 13.9 26.7 74.5 118.9 184.4 223.7 227.8
Deflator (2009 = 100.0)
Chain-weighted personal health care deflator 5 . . . . 9.3 13.5 18.6 28.5 56.3 75.7 100.0 109.9 111.0
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 55.7 39.6 32.9 26.8 22.4 17.1 13.9 12.9 12.4
Health insurance . . . . . . . . . . . . . . . . . . 28.5 47.0 54.8 60.9 65.5 72.6 77.4 78.4 79.2
Private health insurance . . . . . . . . . . . . . 21.3 22.3 24.5 28.4 33.3 34.9 34.7 34.1 34.8
Medicare . . . . . . . . . . . . . . . . . . . . . ... 11.5 13.8 16.7 17.4 18.6 22.2 22.7 22.3
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 8.0 11.3 11.4 11.3 16.1 16.4 17.4 17.9
Federal . . . . . . . . . . . . . . . . . . . . ... 4.3 6.2 6.3 6.6 9.4 10.9 10.7 11.3
State and local . . . . . . . . . . . . . . . . ... 3.7 5.1 5.1 4.8 6.7 5.5 6.7 6.6
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.5 0.4 0.4
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.3 0.3 0.3
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . . . 7.2 5.2 5.2 4.4 3.4 2.8 3.6 3.8 3.8
Other third-party payers and programs 4 . . . . . . 15.8 13.4 12.2 12.3 12.1 10.2 8.7 8.7 8.4
Amount, in billions
Hospital expenditures 6 . . . . . . . . . . . . . . . . $9.0 $27.2 $51.2 $100.5 $250.4 $415.5 $779.7 $981.0 $1,036.1
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 20.6 9.0 8.4 5.4 4.5 3.2 3.3 3.4 3.1
Health insurance . . . . . . . . . . . . . . . . . . 50.7 71.5 74.7 79.7 82.6 86.2 87.4 86.8 87.7
Private health insurance . . . . . . . . . . . . . 35.6 32.5 33.2 36.6 38.5 33.9 36.6 37.7 39.0
Medicare . . . . . . . . . . . . . . . . . . . . . ... 19.7 22.4 26.1 26.9 29.7 27.5 25.8 24.8
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 9.7 9.8 9.2 10.6 17.1 17.1 17.2 17.9
Federal . . . . . . . . . . . . . . . . . . . . ... 5.2 5.4 5.0 6.3 10.3 11.3 10.7 11.5
State and local . . . . . . . . . . . . . . . . ... 4.5 4.4 4.2 4.3 6.8 5.8 6.5 6.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.4 0.3 0.4
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.3 0.2 0.3
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . . . 15.2 9.6 9.3 7.8 6.5 5.3 5.8 5.8 5.8
Other third-party payers and programs 4 . . . . . . 28.6 19.5 16.9 15.0 12.9 10.6 9.3 9.8 9.2
Amount, in billions
Physician and clinical expenditures . . . . . . . . . . $5.6 $14.3 $25.3 $47.7 $158.4 $288.7 $498.7 $597.1 $634.9
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 59.5 45.1 35.9 29.8 18.9 11.1 9.1 9.0 8.9
Health insurance . . . . . . . . . . . . . . . . . . 33.1 48.8 55.2 59.8 67.8 76.4 80.5 80.9 81.1
Private health insurance . . . . . . . . . . . . . 28.7 29.4 31.4 34.8 42.1 47.1 45.9 42.8 42.9
Medicare . . . . . . . . . . . . . . . . . . . . . ... 11.5 13.7 17.4 19.2 20.3 22.5 23.1 22.7
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 4.5 7.0 5.1 4.4 6.7 8.1 10.7 11.0
Federal . . . . . . . . . . . . . . . . . . . . ... 2.4 3.9 2.9 2.6 3.9 5.6 7.4 7.7
State and local . . . . . . . . . . . . . . . . ... 2.1 3.2 2.2 1.8 2.7 2.5 3.3 3.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.3 0.6 0.5 0.5
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.4 0.4 0.4
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.2 0.2 0.1
Other health insurance programs 3 . . . . . . . . 4.4 3.4 3.1 2.4 2.1 2.1 3.5 3.9 3.9
Other third-party payers and programs 4 . . . . . . 7.4 6.1 8.9 10.4 13.3 12.5 10.4 10.0 10.0
See footnotes at end of table.
Amount, in billions
Dental services expenditures . . . . . . . . . . . . . $2.0 $4.7 $8.0 $13.3 $31.6 $62.1 $102.3 $112.8 $117.5
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 96.0 90.0 81.4 65.8 48.3 44.2 41.6 40.8 39.9
Health insurance . . . . . . . . . . . . . . . . . . 3.2 9.5 17.9 33.4 51.2 55.3 57.9 58.8 59.7
Private health insurance . . . . . . . . . . . . . 1.9 4.5 11.7 28.4 47.9 50.3 48.3 47.1 46.5
Medicare . . . . . . . . . . . . . . . . . . . . . ... ... 0.0 ... ... 0.1 0.3 0.4 0.4
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 3.4 4.5 3.8 2.4 3.9 7.5 8.8 9.8
Federal . . . . . . . . . . . . . . . . . . . . ... 1.8 2.5 2.1 1.3 2.2 5.1 5.5 6.5
State and local . . . . . . . . . . . . . . . . ... 1.6 2.0 1.7 1.0 1.7 2.4 3.3 3.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.4 0.7 1.3 1.4
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.3 0.5 0.9 1.0
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.2 0.4 0.3
Other health insurance programs 3 . . . . . . . . 1.3 1.6 1.6 1.2 0.9 0.6 1.1 1.3 1.6
Other third-party payers and programs 4 . . . . . . 0.8 0.4 0.7 0.8 0.6 0.6 0.5 0.4 0.4
Amount, in billions
Home health care expenditures 7 . . . . . . . . . . . $0.1 $0.2 $0.6 $2.4 $12.5 $32.3 $67.3 $83.6 $88.8
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 12.3 9.5 12.7 15.3 17.8 19.2 8.3 9.4 9.9
Health insurance . . . . . . . . . . . . . . . . . . 5.3 37.7 53.0 53.7 66.2 71.8 88.4 87.4 87.0
Private health insurance . . . . . . . . . . . . . 1.8 3.2 7.7 14.7 22.8 24.0 7.3 9.8 10.6
Medicare . . . . . . . . . . . . . . . . . . . . . ... 26.8 30.3 26.8 26.0 26.5 45.0 41.0 39.6
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 6.8 13.8 11.6 17.1 20.9 35.6 36.1 36.1
Federal . . . . . . . . . . . . . . . . . . . . ... 3.2 7.7 6.2 9.2 11.3 23.2 20.4 20.6
State and local . . . . . . . . . . . . . . . . ... 3.2 6.1 5.4 8.0 9.6 12.4 15.7 15.4
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.1
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.0
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.0
Other health insurance programs 3 . . . . . . . . 3.5 1.4 1.1 0.5 0.3 0.3 0.4 0.5 0.7
Other third-party payers and programs 4 . . . . . . 80.7 52.7 34.3 31.1 16.0 9.0 3.3 3.2 3.1
Amount, in billions
Nursing care facilities and continuing care
retirement communities expenditures 8 . . . . . . . $0.8 $4.0 $8.0 $15.3 $44.7 $85.0 $134.9 $152.6 $156.8
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 74.4 49.2 39.5 40.5 40.3 31.9 27.3 26.0 25.6
Health insurance . . . . . . . . . . . . . . . . . . ... 28.5 52.9 51.9 49.0 61.2 66.2 66.7 67.4
Private health insurance . . . . . . . . . . . . . ... 0.2 0.5 1.3 6.2 8.8 7.3 8.0 8.6
Medicare . . . . . . . . . . . . . . . . . . . . . ... 3.5 2.7 2.0 3.8 12.7 22.3 23.3 24.0
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 23.3 47.5 46.2 36.7 37.5 33.7 32.2 31.7
Federal . . . . . . . . . . . . . . . . . . . . ... 12.5 26.1 26.1 20.7 21.8 22.5 18.4 18.2
State and local . . . . . . . . . . . . . . . . ... 10.8 21.4 20.1 16.1 15.7 11.2 13.8 13.5
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.0
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.0
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.0 0.0 0.0 0.0
Other health insurance programs 3 . . . . . . . . ... 1.5 2.2 2.4 2.2 2.2 2.9 3.1 3.2
Other third-party payers and programs 4 . . . . . . 25.5 22.3 7.6 7.6 10.8 6.9 6.5 7.3 7.0
Amount, in billions
Prescription drug expenditures . . . . . . . . . . . . $2.7 $5.5 $8.1 $12.0 $40.3 $121.0 $252.7 $297.9 $324.6
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 96.0 82.4 75.7 71.3 56.8 27.8 19.4 15.0 14.0
Health insurance . . . . . . . . . . . . . . . . . . 1.5 16.5 23.1 26.9 40.3 70.3 79.2 84.3 85.4
Private health insurance . . . . . . . . . . . . . 1.3 8.8 12.0 15.0 27.0 50.5 45.9 43.0 43.1
Medicare . . . . . . . . . . . . . . . . . . . . . ... ... 0.0 ... 0.5 1.7 21.6 28.5 29.0
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 7.6 10.8 11.7 12.6 16.3 8.1 9.4 9.8
Federal . . . . . . . . . . . . . . . . . . . . ... 4.1 5.9 6.8 7.2 9.3 5.4 6.0 6.5
State and local . . . . . . . . . . . . . . . . ... 3.5 4.9 4.9 5.4 7.0 2.7 3.3 3.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.5 0.5 0.5
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.4 0.3 0.3
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.2 0.1 0.1
Other health insurance programs 3 . . . . . . . . 0.1 0.1 0.2 0.2 0.2 1.5 3.1 2.9 3.0
Other third-party payers and programs 4 . . . . . . 2.5 1.1 1.3 1.8 3.0 1.9 1.4 0.7 0.6
See footnotes at end of table.
Amount, in billions
All other personal health care expenditures 9 . . . . . $3.2 $7.1 $12.0 $25.7 $77.3 $157.3 $278.7 $337.8 $358.5
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . 84.6 74.2 66.8 56.9 49.7 37.6 31.6 30.8 30.2
Health insurance . . . . . . . . . . . . . . . . . . 4.1 9.1 16.6 25.7 33.7 45.0 52.2 53.9 55.0
Private health insurance . . . . . . . . . . . . . 3.1 4.6 6.6 7.8 13.0 13.7 14.3 14.2 14.4
Medicare . . . . . . . . . . . . . . . . . . . . . ... 1.0 1.9 2.8 5.5 8.1 10.3 10.3 10.1
Medicaid . . . . . . . . . . . . . . . . . . . . . ... 3.0 7.6 14.8 15.0 22.8 27.0 28.7 29.7
Federal . . . . . . . . . . . . . . . . . . . . ... 1.6 4.2 8.1 8.5 13.0 18.0 16.6 17.4
State and local . . . . . . . . . . . . . . . . ... 1.4 3.4 6.7 6.4 9.8 9.0 12.1 12.4
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.2 0.4 0.4 0.5
Federal . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.3 0.3 0.4
State and local . . . . . . . . . . . . . . . . ... ... ... ... ... 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . . . 1.1 0.5 0.4 0.3 0.2 0.2 0.2 0.3 0.3
Other third-party payers and programs 4 . . . . . . 11.2 16.7 16.6 17.4 16.6 17.4 16.2 15.3 14.8
1
Includes all expenditures other than expenses for government administration, net cost of health insurance, public health activities, research, and structures and
equipment.
2
The Children's Health Insurance Program (CHIP) including Medicaid CHIP expansions.
3
Includes Department of Defense and Department of Veterans Affairs.
4
Includes worksite health care, other private revenues, Indian Health Service, workers' compensation, general assistance, maternal and child health, vocational
rehabilitation, other federal programs, Substance Abuse and Mental Health Services Administration, other state and local programs, and school health.
5
The personal health care deflator is calculated as a chain weighted price index using the Producer Price Indexes for hospitals, offices of physicians, medical and
diagnostic laboratories, home health care services, and nursing care facilities; and Consumer Price Indices specific to each of the remaining personal health care
components. For more information on the detailed price series recommended for deflating each category of spending see the National Health Expenditure Accounts
6
Includes expenditures for hospital-based nursing home and home health agency care.
7
Includes expenditures for care in freestanding facilities only. Additional services of this type are provided in hospital-based facilities and are considered hospital care.
8
Includes expenditures for care in freestanding nursing homes. Expenditures for care in hospital-based nursing homes are included with hospital care.
9
Includes expenditures for other professional services, other nondurable medical products, durable medical equipment, and other health, residential, and personal care,
NOTES: Percents may not add to totals because of rounding. Census resident-based population less armed forces overseas and population of outlying areas used
to calculate per capita. The Medicare and Medicaid programs began coverage in 1965. The Children's Health Insurance Program began coverage in 1997. For more
information on NHE sources and methods, see the National Health Expenditure Accounts Methodology Paper, 2015. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/DSM-15.pdf. See Appendix I,
National Health Expenditure Accounts (NHEA). Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
expenditures. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html,
accessed on January 13, 2017. Martin AB, Hartman M, Washington B, Catlin A. National health spending: Faster growth in 2015 as coverage expands and utilization
increases. Health Aff 2016;36(1):111. See Appendix I, National Health Expenditure Accounts (NHEA).
All ages
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . $13,782 $19,186 $19,266 8,743,631 9,637,687 8,308,949 $119,757 $184,725 $159,951
Laminectomy (back surgery) . . . . . . . . . . . . 8,493 11,920 14,883 285,636 204,786 151,705 2,436 2,440 2,268
Heart valve procedures . . . . . . . . . . . . . . . 44,609 56,426 51,896 79,719 98,101 110,915 3,550 5,541 5,756
Coronary artery bypass graft (CABG) . . . . . . . 32,520 41,897 41,932 337,972 164,801 160,240 11,028 6,907 6,717
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . 15,587 20,957 21,448 581,183 488,521 377,475 9,057 10,240 8,104
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator 28,757 38,023 34,974 66,286 122,847 78,970 1,921 4,667 2,762
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . 20,241 25,560 23,616 253,780 261,401 234,290 5,244 6,678 5,529
Appendectomy . . . . . . . . . . . . . . . . . . . . 7,616 9,934 10,657 269,089 273,753 177,550 2,027 2,719 1,897
Cholecystectomy (gall bladder removal) . . . . . 10,811 13,767 13,327 389,079 379,753 300,245 4,170 5,232 4,006
Hysterectomy . . . . . . . . . . . . . . . . . . . . . 6,790 9,617 10,394 580,019 354,313 184,950 3,910 3,411 1,923
Cesarean section . . . . . . . . . . . . . . . . . . . 5,646 6,313 6,150 898,859 1,226,435 1,142,680 4,956 7,750 7,032
Treatment, fracture or dislocation of hip
and femur. . . . . . . . . . . . . . . . . . . . . . . 13,072 18,814 17,286 237,615 248,777 246,135 3,159 4,678 4,255
Arthroplasty knee (knee replacement) . . . . . . . 14,357 17,592 16,292 318,854 693,086 723,086 4,551 12,198 11,783
Hip replacement . . . . . . . . . . . . . . . . . . . 15,568 18,820 17,079 295,940 437,380 487,625 4,664 8,229 8,328
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . 18,119 30,933 28,949 204,320 444,508 413,206 3,614 13,755 11,970
Under 18 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . 13,831 21,126 28,582 382,455 413,852 297,290 5,112 8,759 8,457
Incision and excision of CNS (a type
of brain surgery) . . . . . . . . . . . . . . . . . . . 30,026 44,269 47,633 6,352 8,925 7,870 184 396 372
Tonsillectomy and/or adenoidectomy . . . . . . . 4,597 6,465 7,897 12,045 13,000 8,635 57 85 69
Small bowel resection (removal of part of
the small bowel) . . . . . . . . . . . . . . . . . . . 37,710 44,954 60,727 1,712 2,694 1,855 64 120 112
Appendectomy . . . . . . . . . . . . . . . . . . . . 6,833 9,206 10,336 75,481 79,575 46,745 502 733 483
Cesarean section . . . . . . . . . . . . . . . . . . . 6,269 6,718 6,594 23,690 22,582 12,090 134 152 80
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . 30,463 56,100 60,000 7,463 10,628 10,995 224 596 658
1844 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . 9,107 12,588 12,289 2,806,078 2,842,807 2,339,211 25,005 35,784 28,735
Incision and excision of CNS (a type
of brain surgery) . . . . . . . . . . . . . . . . . . . 26,477 39,120 37,330 19,510 22,908 18,660 497 902 699
Laminectomy (back surgery) . . . . . . . . . . . . 7,643 11,222 14,038 95,687 44,303 27,800 736 498 392
Appendectomy . . . . . . . . . . . . . . . . . . . . 7,014 9,112 9,519 133,662 116,699 71,470 924 1,064 683
Cholecystectomy (gall bladder removal) . . . . . 8,855 10,939 10,747 132,538 139,244 102,825 1,127 1,526 1,108
Oophorectomy (removal of one or both ovaries). 6,602 9,584 10,800 38,252 32,130 17,915 255 308 193
Ligation of fallopian tubes ("tying" of
fallopian tubes) . . . . . . . . . . . . . . . . . . . 4,882 5,546 7,516 75,221 44,524 31,045 346 247 230
Hysterectomy . . . . . . . . . . . . . . . . . . . . . 6,296 8,729 9,481 291,704 149,442 72,870 1,811 1,306 691
Cesarean section . . . . . . . . . . . . . . . . . . . 5,628 6,300 6,141 873,231 1,198,961 1,126,890 4,809 7,561 6,925
Treatment, fracture or dislocation of lower
extremity (other than hip or femur) . . . . . . . . 9,702 15,136 17,248 68,015 59,800 45,040 648 904 776
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . 17,033 29,044 27,341 73,228 89,655 64,600 1,206 2,605 1,768
See footnotes at end of table.
4564 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . $15,076 $21,513 $21,420 2,435,212 3,085,028 2,636,652 $36,552 $66,262 $56,404
Laminectomy (back surgery) . . . . . . . . . . . . . 8,567 12,311 15,482 107,720 80,487 59,585 924 990 927
Heart valve procedures . . . . . . . . . . . . . . . . 41,898 54,544 50,655 22,849 28,546 28,045 951 1,558 1,421
Coronary artery bypass graft (CABG) . . . . . . . . 30,385 40,362 39,934 139,897 73,265 67,165 4,271 2,958 2,682
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . 15,086 20,557 20,751 252,151 224,713 170,935 3,796 4,620 3,550
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator . 35,219 40,063 37,584 15,957 36,456 23,770 558 1,460 893
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . 18,207 23,500 22,622 76,604 99,837 90,725 1,422 2,349 2,050
Cholecystectomy (gall bladder removal) . . . . . . 10,197 13,874 13,322 117,432 120,321 97,220 1,198 1,670 1,297
Oophorectomy (removal of one or both ovaries). . 7,903 10,736 13,172 21,232 37,253 22,565 168 400 297
Hysterectomy . . . . . . . . . . . . . . . . . . . . . . 6,926 9,742 10,369 231,498 164,344 88,465 1,601 1,603 918
Arthroplasty knee (knee replacement) . . . . . . . . 14,687 17,632 16,404 95,902 291,502 303,150 1,402 5,141 4,973
Hip replacement . . . . . . . . . . . . . . . . . . . . 16,180 18,471 16,915 65,118 150,253 176,055 1,061 2,774 2,976
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . 17,391 29,546 27,210 87,388 218,349 193,710 1,480 6,454 5,272
6574 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . 16,890 22,719 22,079 1,511,467 1,648,763 1,623,736 25,661 37,391 35,822
Laminectomy (back surgery) . . . . . . . . . . . . . 8,975 11,479 14,571 45,976 43,879 36,780 413 503 538
Heart valve procedures . . . . . . . . . . . . . . . . 45,656 56,733 50,565 23,236 26,078 29,145 1,052 1,481 1,473
Coronary artery bypass graft (CABG) . . . . . . . . 33,093 41,966 42,230 112,652 53,818 56,070 3,726 2,258 2,367
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . 15,519 21,035 21,929 166,497 125,005 99,675 2,579 2,629 2,189
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator . 31,418 39,604 36,477 19,096 32,601 20,425 603 1,290 746
Endarterectomy (plaque removal from artery
lining of brain, head, neck) . . . . . . . . . . . . . . 9,044 10,830 10,809 51,292 34,638 30,055 476 375 325
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . 20,355 26,106 23,350 63,693 59,112 58,000 1,336 1,539 1,354
Cholecystectomy (gall bladder removal) . . . . . . 11,945 15,967 15,122 65,953 52,412 48,435 801 836 733
Arthroplasty knee (knee replacement) . . . . . . . . 14,623 17,438 16,075 110,961 232,195 264,425 1,607 4,053 4,253
Hip replacement . . . . . . . . . . . . . . . . . . . . 15,508 18,526 16,729 71,986 106,955 135,840 1,133 1,981 2,273
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . 19,151 32,385 29,609 23,419 84,861 100,785 446 2,748 2,986
7584 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . 17,144 22,844 22,152 1,224,573 1,189,769 1,010,816 21,299 27,126 22,392
Laminectomy (back surgery) . . . . . . . . . . . . . 9,684 11,627 14,173 31,059 28,311 21,510 304 329 307
Heart valve procedures . . . . . . . . . . . . . . . . 47,093 58,243 52,058 21,004 26,690 30,675 1,001 1,555 1,597
Coronary artery bypass graft (CABG) . . . . . . . . 35,880 44,789 45,596 68,750 29,874 29,395 2,486 1,339 1,340
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . 16,431 21,714 22,467 111,169 87,441 63,865 1,838 1,899 1,437
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator . 25,771 36,946 33,177 19,975 33,287 19,725 524 1,228 654
Endarterectomy (plaque removal from artery
lining of brain, head, neck) . . . . . . . . . . . . . . 9,395 11,012 11,049 45,337 28,078 23,495 439 309 260
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . 22,198 28,167 24,861 62,096 48,800 39,230 1,416 1,372 975
Cholecystectomy (gall bladder removal) . . . . . . 13,689 18,110 16,705 52,448 42,922 33,660 733 777 563
Treatment, fracture or dislocation of hip
and femur. . . . . . . . . . . . . . . . . . . . . . . . 12,310 17,392 16,203 73,332 66,038 63,765 930 1,150 1,034
Arthroplasty knee (knee replacement) . . . . . . . . 14,615 17,530 16,188 79,138 133,319 123,855 1,158 2,338 2,006
Hip replacement . . . . . . . . . . . . . . . . . . . . 15,321 19,155 17,336 92,715 102,563 100,695 1,443 1,964 1,746
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . 19,927 32,830 29,844 11,770 36,462 39,065 233 1,197 1,166
See footnotes at end of table.
1
Data are based on valid operating room procedures. Analysis is limited to procedures identified as operating room procedures based on the Centers for Medicare &
Medicaid Services' Diagnosis Related Groups (DRGs). For DRGs, physician panels identified International Classification of Diseases (ICD9CM) procedure codes that
would be performed in operating rooms in most hospitals. Operating room procedures are classified by the Clinical Classifications Software (CCS) that group ICD9
CM procedure codes into 1 of 231 clinically meaningful categories. Mean costs per hospitalization are based on the principal procedure as determined by the CCS.
The number of discharges is based on the first-listed (principal) operating room procedure. See Appendix II, Procedure.
2
Charges (the amount billed by the hospital) were converted to costs using cost-to-charge ratios from the Centers for Medicare & Medicaid Services. Costs are for the
entire hospitalization including the principal procedure. Costs were adjusted for inflation to 2014 dollars using the gross domestic product deflator Table 1.1.4. Price
Indexes downloaded from https://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1 on November 21, 2016. See Appendix II, Cost to charge ratio.
3
Includes discharges for operating room principal procedures not shown separately.
NOTES: Excludes newborn infants. The number of states participating in the sample varied over time from 28 states in 2000 to 46 in 2011, 44 in 2012, 43 states and
D.C. in 2013, and 44 states and D.C. in 2014. See Appendix I, Healthcare Cost and Utilization Project (HCUP), National (Nationwide) Inpatient Sample, for a list of states
available in each year. In 2012, the HCUP-NIS was redesigned and changed from a sample of hospitals to a sample of discharges from all participating community
hospitals. For this report, the statistics for years prior to 2012 were regenerated using new trend weights taking into account the 2012 redesign. For more information on
the 2012 redesign, see: Houchens R, Ross D, Elixhauser A, Jiang J. Nationwide Inpatient Sample (NIS) redesign final report. 2014. HCUP methods series report
# 2014-04 ONLINE. April 4, 2014. U.S. Agency for Healthcare Research and Quality. Available from: http://www.hcup-us.ahrq.gov/reports/methods/2014-04.pdf. The
estimates are weighted to provide national estimates. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/
hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been
revised and differ from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, National (Nationwide) Inpatient Sample. See Appendix I, Healthcare
Cost and Utilization Project (HCUP), National (Nationwide) Inpatient Sample.
Total expenses 1
Mean annual
Percent of expense
Population persons with per person
in millions 2 expense with expense 3
Characteristic 1997 2000 2013 1987 1997 2000 2013 1987 1997 2000 2013
All ages . . . . . . . . . . . . . . . . . . . . . . . 271.3 278.4 315.7 84.5 84.1 83.5 84.4 $3,193 $3,518 $3,653 $5,256
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . 237.1 243.6 269.3 83.2 82.5 81.8 82.5 2,482 2,668 2,877 4,282
Under 6 years . . . . . . . . . . . . . . . . 23.8 24.1 23.9 88.9 88.0 86.7 90.3 2,118 1,245 1,520 2,850
617 years . . . . . . . . . . . . . . . . . . 48.1 48.4 50.1 80.2 81.7 80.0 85.4 1,380 1,398 1,512 2,044
1844 years . . . . . . . . . . . . . . . . . 108.9 109.0 112.1 81.5 78.3 77.7 75.4 2,180 2,417 2,577 3,655
4564 years . . . . . . . . . . . . . . . . . 56.3 62.1 83.2 87.0 89.2 88.5 88.0 4,231 4,682 4,819 6,737
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 118.0 120.9 133.7 78.8 77.6 76.6 77.6 2,345 2,411 2,754 3,835
Female. . . . . . . . . . . . . . . . . . . . . . 119.1 122.7 135.6 87.5 87.4 87.0 87.3 2,601 2,894 2,984 4,673
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . 29.4 32.0 51.0 71.0 69.5 69.0 72.2 1,986 2,220 1,960 2,995
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 166.2 169.2 160.4 86.9 87.2 86.6 87.7 2,488 2,862 3,011 4,712
Black or African American. . . . . . . . . 31.3 32.1 34.0 72.2 72.1 71.3 77.2 3,016 2,139 3,056 4,332
Asian . . . . . . . . . . . . . . . . . . . . . ... ... 14.8 ... ... ... 73.5 ... ... ... 2,912
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . ... ... 9.1 ... ... ... 83.0 ... ... ... 4,347
Insurance status 5
Any private insurance . . . . . . . . . . . . . 174.0 181.6 174.3 86.5 86.5 85.9 88.0 2,379 2,719 2,741 4,401
Public insurance only . . . . . . . . . . . . . 29.8 29.7 54.6 82.4 83.3 83.6 85.2 4,006 3,243 4,368 4,777
Uninsured all year . . . . . . . . . . . . . . . 33.3 32.3 40.3 61.8 61.1 57.3 54.9 1,529 1,593 2,029 2,416
Medicare only . . . . . . . . . . . . . . . . . 8.8 12.0 16.9 85.9 92.1 94.8 93.3 6,221 7,952 7,131 9,271
Medicare and private insurance . . . . . . . 21.7 19.2 21.9 95.4 97.0 96.0 97.3 7,818 8,418 8,517 9,980
Medicare and other public coverage . . . . 3.2 3.2 6.8 94.4 93.2 96.3 96.8 12,154 12,166 11,398 13,176
See footnotes at end of table.
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . 54.0 58.7 58.5 55.6 139 208 269 217
Under 6 years . . . . . . . . . . . . . . . . 61.8 61.3 56.9 48.6 49 51 50 28
617 years . . . . . . . . . . . . . . . . . . 44.3 48.2 46.2 43.2 93 78 95 84
1844 years . . . . . . . . . . . . . . . . . 51.3 55.9 56.0 50.6 109 176 205 155
4564 years . . . . . . . . . . . . . . . . . 65.3 71.8 73.3 71.8 265 386 508 361
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 46.5 51.5 51.3 49.5 129 185 236 214
Female. . . . . . . . . . . . . . . . . . . . . . 61.4 65.8 65.6 61.6 147 225 295 220
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . 41.6 47.7 45.0 42.9 101 138 198 142
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 57.7 63.1 63.8 61.9 146 224 289 248
Black or African American. . . . . . . . . 44.1 50.0 47.6 52.0 124 167 222 160
Asian . . . . . . . . . . . . . . . . . . . . . ... ... ... 40.6 ... ... ... 193
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . ... ... ... 52.2 ... ... ... 160
Insurance status 5
Any private insurance . . . . . . . . . . . . . 56.5 61.6 61.6 59.6 144 197 231 224
Public insurance only . . . . . . . . . . . . . 56.5 62.0 62.4 56.9 96 204 385 114
Uninsured all year . . . . . . . . . . . . . . . 35.1 40.2 37.6 36.1 153 300 446 388
Medicare only . . . . . . . . . . . . . . . . . 70.6 82.1 87.7 88.6 480 810 1,007 423
Medicare and private insurance . . . . . . . 83.4 88.1 89.0 91.9 452 711 780 518
Medicare and other public coverage . . . . 88.2 85.0 88.5 91.9 163 392 668 211
See footnotes at end of table.
NOTES: Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel
Survey (MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be more
comparable with MEPS by using estimated charge-to-payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987 NMES
expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS to the
1987 NMES. Inquiry 2002;39(1):76-86. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 19962013
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
Percent distribution
All ages . . . . . . . . . . . . . . . . . . . . . . . 100.0 24.8 19.4 19.4 13.8 36.6 40.3 40.3 39.6
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . 100.0 26.2 21.1 20.3 14.5 46.6 53.1 52.5 52.6
Under 6 years . . . . . . . . . . . . . . . . 100.0 18.5 14.2 10.3 6.0 39.5 49.3 51.2 52.9
617 years . . . . . . . . . . . . . . . . . . 100.0 35.7 29.0 27.7 17.7 47.3 53.2 48.8 50.9
1844 years . . . . . . . . . . . . . . . . . 100.0 27.4 21.1 19.9 15.2 46.8 52.9 51.2 54.6
4564 years . . . . . . . . . . . . . . . . . 100.0 24.0 20.1 20.2 14.6 47.8 53.6 54.5 51.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 100.0 24.5 21.3 18.1 13.8 44.6 50.3 52.2 50.1
Female. . . . . . . . . . . . . . . . . . . . . . 100.0 27.5 21.0 22.1 15.0 48.1 55.1 52.7 54.4
Hispanic origin and race 2
Hispanic or Latino . . . . . . . . . . . . . . . 100.0 22.0 18.8 20.5 12.3 36.1 42.3 45.8 34.4
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 100.0 28.2 21.8 21.7 15.8 50.1 55.8 55.1 58.3
Black or African American. . . . . . . . . 100.0 15.5 17.1 11.8 8.2 30.0 42.3 40.5 38.7
Asian . . . . . . . . . . . . . . . . . . . . . 100.0 ... ... ... 18.4 ... ... ... 59.4
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . 100.0 ... ... ... 13.6 ... ... ... 40.8
Insurance status 3
Any private insurance . . . . . . . . . . . . . 100.0 29.0 21.6 21.2 16.3 60.0 67.6 70.2 73.7
Public insurance only . . . . . . . . . . . . . 100.0 8.9 10.6 9.8 4.5 ... ... ... ...
Uninsured all year . . . . . . . . . . . . . . . 100.0 40.6 41.3 40.4 33.8 ... ... ... ...
65 years and over . . . . . . . . . . . . . . . . . 100.0 22.0 16.3 17.5 12.2 15.8 16.5 14.9 12.0
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 100.0 21.7 14.2 14.2 11.6 17.6 20.1 16.8 11.2
Female. . . . . . . . . . . . . . . . . . . . . . 100.0 22.2 18.1 20.2 12.7 14.4 13.2 13.3 12.6
Hispanic origin and race 2
Hispanic or Latino . . . . . . . . . . . . . . . 100.0 *13.5 13.6 13.9 6.4 *4.7 5.9 8.4 5.4
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 100.0 23.7 17.0 18.3 13.2 16.7 17.9 15.2 12.7
Black or African American. . . . . . . . . 100.0 11.2 11.4 13.6 8.3 *11.9 8.8 9.3 8.9
Asian . . . . . . . . . . . . . . . . . . . . . 100.0 ... ... ... 10.0 ... ... ... *20.1
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . 100.0 ... ... ... * ... ... ... *
Insurance status
Medicare only . . . . . . . . . . . . . . . . . 100.0 29.8 19.8 22.2 12.6 ... ... ... ...
Medicare and private insurance . . . . . . . 100.0 23.4 17.3 17.0 14.8 18.9 25.7 25.3 24.3
Medicare and other public coverage . . . . 100.0 *6.2 5.2 9.1 5.1 ... ... ... ...
See footnotes at end of table.
Percent distribution
All ages . . . . . . . . . . . . . . . . . . . . . . . 34.1 34.4 35.4 42.1 4.5 5.9 5.0 4.6
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . 21.3 18.1 21.3 27.3 6.0 7.7 6.0 5.5
Under 6 years . . . . . . . . . . . . . . . . 35.8 25.4 33.6 37.6 6.2 11.2 4.9 *3.4
617 years . . . . . . . . . . . . . . . . . . 11.8 14.1 20.1 29.6 5.2 3.7 3.4 1.8
1844 years . . . . . . . . . . . . . . . . . 19.4 15.7 21.1 24.0 6.4 10.3 7.8 6.2
4564 years . . . . . . . . . . . . . . . . . 22.4 20.3 20.2 27.8 5.8 6.0 5.2 6.0
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 23.9 19.5 23.5 29.7 7.1 8.9 6.3 6.4
Female. . . . . . . . . . . . . . . . . . . . . . 19.2 17.0 19.5 25.7 5.2 6.8 5.7 4.9
Hispanic origin and race 2
Hispanic or Latino . . . . . . . . . . . . . . . 35.8 28.9 27.5 42.4 6.0 10.0 6.2 10.8
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 15.9 15.3 18.0 21.3 5.8 7.1 5.2 4.6
Black or African American. . . . . . . . . 47.2 30.7 38.8 46.4 7.3 9.9 8.8 6.8
Asian . . . . . . . . . . . . . . . . . . . . . ... ... ... 17.9 ... ... ... 4.4
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . ... ... ... 42.8 ... ... ... *2.8
Insurance status 3
Any private insurance . . . . . . . . . . . . . 6.2 6.6 5.3 8.1 4.8 4.2 3.3 1.9
Public insurance only . . . . . . . . . . . . . 87.2 80.7 84.4 90.6 3.9 8.7 5.8 *4.8
Uninsured all year . . . . . . . . . . . . . . . 28.6 7.5 *21.2 7.7 30.9 51.1 38.4 58.5
65 years and over . . . . . . . . . . . . . . . . . 60.8 64.8 64.7 73.3 1.5 2.5 2.9 2.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 58.8 63.4 66.9 74.7 *1.9 2.3 2.2 2.5
Female. . . . . . . . . . . . . . . . . . . . . . 62.3 65.9 63.0 72.2 1.1 2.7 3.5 2.6
Hispanic origin and race 2
Hispanic or Latino . . . . . . . . . . . . . . . 80.2 77.8 75.6 86.2 *1.6 *2.7 *2.2 2.0
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . 58.0 62.6 64.1 71.4 1.6 2.5 2.4 2.7
Black or African American. . . . . . . . . 76.3 77.6 68.3 80.7 0.6 2.2 *8.9 *2.0
Asian . . . . . . . . . . . . . . . . . . . . . ... ... ... 68.3 ... ... ... 1.6
American Indian, Alaska Native, Native
Hawaiian, Other Pacific Islander,
and Multiple Race . . . . . . . . . . . . . ... ... ... * ... ... ... *
Insurance status
Medicare only . . . . . . . . . . . . . . . . . 68.8 72.4 72.2 81.1 1.4 7.7 5.7 6.4
Medicare and private insurance . . . . . . . 56.1 56.3 57.1 60.6 1.6 0.6 *0.6 *0.2
Medicare and other public coverage . . . . 92.9 92.7 87.3 93.5 1.0 *2.3 *4.0 1.3
NOTES: Includes persons in the civilian noninstitutionalized population for all or part of the year. Expenses for persons in this population for only part of the year are
restricted to those incurred during periods of eligibility (e.g., expenses incurred during periods of institutionalization and military service are not included in estimates).
Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel Survey
(MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be more
comparable with MEPS using estimated charge-to-payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987 NMES
expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS to the
1987 NMES. Inquiry 2002;39(1):76-86. Percents sum to 100 across sources within years. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 19962013
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error equal to or greater than 30%.
1
Estimates of expenses were converted to 2013 dollars using the Consumer Price Index (all items). See Appendix II, Consumer Price Index (CPI).
NOTES: Includes persons in the civilian noninstitutionalized population for all or part of the year. Expenses for persons in this population for only part of the year are
restricted to those incurred during periods of eligibility (e.g., expenses incurred during periods of institutionalization and military service are not included in estimates).
Out-of-pocket expenses include expenditures for inpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines,
home health services, dental services, and various other medical equipment, supplies, and services that were purchased or rented during the year. Out-of-pocket
expenses for over-the-counter medications, phone contacts with health providers, and premiums for health insurance policies are not included in these estimates.
Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel Survey
(MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be more
comparable with MEPS using estimated charge-to-payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987 NMES
expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS to the
1987 NMES. Inquiry 2002;39(1):76-86. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 19972013
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
Type of sponsor 1987 1990 2000 2009 2012 2013 2014 2015
Amount, in billions
National health expenditures . . . . . . . . . . . . . . . . . . . $516.5 $721.4 $1,369.7 $2,494.7 $2,795.4 $2,877.6 $3,029.3 $3,205.6
Businesses, households, and other private revenues . . . . . 353.6 488.2 883.0 1,409.4 1,576.2 1,611.1 1,662.8 1,739.4
Private business . . . . . . . . . . . . . . . . . . . . . . . 115.9 170.6 335.2 513.7 567.0 578.5 605.6 637.5
Private business contribution to employer-sponsored
private health insurance premiums 1 . . . . . . . . . . . 78.1 121.8 244.1 397.0 433.5 440.5 460.5 484.8
Employer Medicare hospital insurance trust
fund payroll taxes 2 . . . . . . . . . . . . . . . . . . . . 24.4 29.4 61.8 77.1 87.3 89.7 94.3 98.8
Workers' compensation and temporary
disability insurance. . . . . . . . . . . . . . . . . . . . 11.7 17.1 25.9 35.0 41.1 42.9 45.1 47.9
Worksite health care . . . . . . . . . . . . . . . . . . . 1.7 2.2 3.5 4.6 5.2 5.4 5.7 6.1
Household . . . . . . . . . . . . . . . . . . . . . . . . . . 196.6 261.1 443.5 728.1 807.2 824.9 846.6 886.8
Household contribution to employer-sponsored
private health insurance premiums 3 . . . . . . . . . . . 29.4 48.9 102.3 213.0 233.7 236.3 235.2 251.3
Household contribution to direct purchase insurance . . 11.5 15.7 25.8 38.7 48.1 50.0 54.3 59.5
Medical portion of property and casualty insurance 4 . . . 10.5 12.8 17.6 27.8 29.0 30.4 32.4 34.5
Employee and self-employment payroll taxes and
voluntary premiums paid to Medicare hospital
insurance trust fund 5. . . . . . . . . . . . . . . . . . . 29.4 35.7 82.5 108.2 125.5 123.7 132.2 139.3
Premiums paid by individuals to Medicare
supplementary medical insurance trust fund and
the pre-existing condition insurance plan 6 . . . . . . . 6.2 10.2 16.3 47.3 53.4 59.3 62.9 64.1
Out-of-pocket health spending . . . . . . . . . . . . . . 109.7 137.9 199.0 293.1 317.6 325.1 329.7 338.1
Other private revenues 7 . . . . . . . . . . . . . . . . . . . 41.1 56.5 104.2 167.6 201.9 207.7 210.5 215.1
Governments . . . . . . . . . . . . . . . . . . . . . . . . . . 162.9 233.2 486.7 1,085.3 1,219.2 1,266.5 1,366.5 1,466.2
Federal government . . . . . . . . . . . . . . . . . . . . . 85.2 124.1 260.7 680.2 731.2 759.4 843.1 918.5
Federal government contribution to employer-sponsored
private health insurance premiums . . . . . . . . . . . 4.9 9.9 14.3 26.8 31.0 32.4 33.2 33.9
Employer Medicare hospital insurance trust
fund payroll taxes . . . . . . . . . . . . . . . . . . . . 1.7 2.0 2.7 3.9 4.1 4.1 4.1 4.2
Marketplace tax credits and subsidies 8. . . . . . . . . . ... ... ... ... ... ... 17.3 29.2
Federal general revenue and Medicare net
trust fund expenditures 9 . . . . . . . . . . . . . . . . . 17.7 27.7 49.4 231.7 265.9 278.9 289.6 303.6
Federal portion of Medicaid payments . . . . . . . . . . 27.9 42.6 116.8 247.3 243.3 256.9 305.5 344.0
Medicare buy-in premiums 10 . . . . . . . . . . . . . . . 0.3 0.7 2.5 7.7 7.8 8.3 8.4 8.6
Retiree drug subsidy payments to employer-sponsored
health insurance plans . . . . . . . . . . . . . . . . . . ... ... ... 3.9 3.0 1.7 1.6 1.4
Other federal health insurance and programs 11. . . . . . 32.7 41.3 75.1 158.9 176.0 177.1 183.5 193.6
State and local government . . . . . . . . . . . . . . . . . 77.7 109.1 226.0 405.1 488.1 507.1 523.4 547.7
State and local government contribution to employer
sponsored private health insurance premiums 12 . . . . 14.8 24.8 54.4 123.2 146.6 153.4 165.1 177.0
Employer Medicare hospital insurance trust
fund payroll taxes . . . . . . . . . . . . . . . . . . . . 3.1 4.1 7.9 12.0 12.0 12.2 12.5 12.9
State portion of Medicaid payments . . . . . . . . . . . 22.5 31.1 83.5 127.1 179.5 188.5 191.7 201.1
Medicare buy-in premiums 10 . . . . . . . . . . . . . . . 0.2 0.5 1.8 3.5 5.4 5.7 5.8 5.9
Other programs 13 . . . . . . . . . . . . . . . . . . . . . 37.0 48.6 78.4 139.2 144.5 147.4 148.3 150.8
Percent distribution
National health expenditures . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Businesses, households, and other private revenues . . . . . 68.5 67.7 64.5 56.5 56.4 56.0 54.9 54.3
Private business . . . . . . . . . . . . . . . . . . . . . . . 22.4 23.6 24.5 20.6 20.3 20.1 20.0 19.9
Private business contribution to employer-sponsored
private health insurance premiums 1 . . . . . . . . . . . 15.1 16.9 17.8 15.9 15.5 15.3 15.2 15.1
Employer Medicare hospital insurance trust
fund payroll taxes 2 . . . . . . . . . . . . . . . . . . . . 4.7 4.1 4.5 3.1 3.1 3.1 3.1 3.1
Workers' compensation and temporary
disability insurance. . . . . . . . . . . . . . . . . . . . 2.3 2.4 1.9 1.4 1.5 1.5 1.5 1.5
Worksite health care . . . . . . . . . . . . . . . . . . . 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2
Household . . . . . . . . . . . . . . . . . . . . . . . . . . 38.1 36.2 32.4 29.2 28.9 28.7 27.9 27.7
Household contribution to employer-sponsored
private health insurance premiums 3 . . . . . . . . . . . 5.7 6.8 7.5 8.5 8.4 8.2 7.8 7.8
Household contribution to direct purchase insurance . . 2.2 2.2 1.9 1.6 1.7 1.7 1.8 1.9
Medical portion of property and casualty insurance 4 . . . 2.0 1.8 1.3 1.1 1.0 1.1 1.1 1.1
Employee and self-employment payroll taxes and
voluntary premiums paid to Medicare hospital
insurance trust fund 5. . . . . . . . . . . . . . . . . . . 5.7 4.9 6.0 4.3 4.5 4.3 4.4 4.3
Premiums paid by individuals to Medicare
supplementary medical insurance trust fund and
the pre-existing condition insurance plan 6 . . . . . . . 1.2 1.4 1.2 1.9 1.9 2.1 2.1 2.0
Out-of-pocket health spending . . . . . . . . . . . . . . 21.2 19.1 14.5 11.7 11.4 11.3 10.9 10.5
Other private revenues 7 . . . . . . . . . . . . . . . . . . . 8.0 7.8 7.6 6.7 7.2 7.2 6.9 6.7
See footnotes at end of table.
Type of sponsor 1987 1990 2000 2009 2012 2013 2014 2015
Percent distribution
Governments . . . . . . . . . . . . . . . . . . . . . . . . . . 31.5 32.3 35.5 43.5 43.6 44.0 45.1 45.7
Federal government . . . . . . . . . . . . . . . . . . . . . 16.5 17.2 19.0 27.3 26.2 26.4 27.8 28.7
Federal government contribution to employer-sponsored
private health insurance premiums . . . . . . . . . . . 0.9 1.4 1.0 1.1 1.1 1.1 1.1 1.1
Employer Medicare hospital insurance trust
fund payroll taxes . . . . . . . . . . . . . . . . . . . . 0.3 0.3 0.2 0.2 0.1 0.1 0.1 0.1
Marketplace tax credits and subsidies 8. . . . . . . . . . ... ... ... ... ... ... 0.6 0.9
Federal general revenue and Medicare net
trust fund expenditures 9 . . . . . . . . . . . . . . . . . 3.4 3.8 3.6 9.3 9.5 9.7 9.6 9.5
Federal portion of Medicaid payments . . . . . . . . . . 5.4 5.9 8.5 9.9 8.7 8.9 10.1 10.7
Medicare buy-in premiums 10 . . . . . . . . . . . . . . . 0.1 0.1 0.2 0.3 0.3 0.3 0.3 0.3
Retiree drug subsidy payments to employer-sponsored
health insurance plans . . . . . . . . . . . . . . . . . . ... ... ... 0.2 0.1 0.1 0.1 0.0
Other federal health insurance and programs 11. . . . . . 6.3 5.7 5.5 6.4 6.3 6.2 6.1 6.0
State and local government . . . . . . . . . . . . . . . . . 15.0 15.1 16.5 16.2 17.5 17.6 17.3 17.1
State and local government contribution to employer
sponsored private health insurance premiums 12 . . . . 2.9 3.4 4.0 4.9 5.2 5.3 5.5 5.5
Employer Medicare hospital insurance trust
fund payroll taxes . . . . . . . . . . . . . . . . . . . . 0.6 0.6 0.6 0.5 0.4 0.4 0.4 0.4
State portion of Medicaid payments . . . . . . . . . . . 4.4 4.3 6.1 5.1 6.4 6.6 6.3 6.3
Medicare buy-in premiums 10 . . . . . . . . . . . . . . . 0.0 0.1 0.1 0.1 0.2 0.2 0.2 0.2
Other programs 13 . . . . . . . . . . . . . . . . . . . . . 7.2 6.7 5.7 5.6 5.2 5.1 4.9 4.7
NOTES: This table disaggregates health expenditures according to five classes of sponsors: businesses, households (individuals), federal government, state and
local governments, and nonpatient revenue sources such as philanthropy. Where businesses or households pay dedicated funds into government health programs
(for example, Medicare) or employers and employees share in the cost of health premiums, these costs are assigned to businesses or households accordingly. This
results in a lower share of expenditures being assigned to the federal government than for tabulations of expenditures by source of funds. Estimates of national health
expenditure by source of funds aim to track government-sponsored health programs over time and do not delineate the role of business employers in paying for health
care. Some of the sponsor categories were revised or added in 2014 to account for changes in the health care system. See Appendix I, National Health Expenditure
Accounts (NHEA). Estimates may not sum to totals because of rounding. For more information on NHE categories, sources, and methods, see the National Health
Expenditure Accounts Methodology Paper, 2015. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group. Businesses, Households, and Governments. National
Health Expenditure Accounts, National health expenditures. Available from:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html,
accessed on January 14, 2017. See Appendix I, National Health Expenditure Accounts (NHEA).
Characteristic 1999 2000 2005 2008 2010 2013 2014 2015 2016
NOTES: Costs are calculated annually from March survey data. Total compensation includes wages, salaries and benefits. See Appendix II, Employer costs for
employee compensation. See Health, United States, 2013, Table 121 for prior years of data. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, National Compensation Survey: Employer Costs for Employee Compensation Annual, 19992001;
Quarterly, 20022003; March release, 20042016. Available from: http://www.bls.gov/ncs/ect/. See Appendix I, National Compensation Survey (NCS).
Number, in millions
Total 4
. . . . . . . . . . . . . . . . . . . . . . . 157.5 165.8 174.0 174.7 163.9 164.9 165.3 170.7 176.6
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . 76.8 70.7 71.5 68.2 61.7 61.8 61.8 63.7 65.5
Age
Under 19 years . . . . . . . . . . . . . . . . . . 72.6 66.1 66.7 62.3 54.3 53.6 53.5 54.1 55.0
Under 6 years . . . . . . . . . . . . . . . . . . 68.1 61.3 62.7 56.6 48.3 48.4 47.3 50.2 51.0
618 years . . . . . . . . . . . . . . . . . . . 74.8 68.4 68.5 64.9 57.2 56.0 56.3 55.9 56.7
Under 18 years . . . . . . . . . . . . . . . . . . 72.6 66.1 66.6 62.1 54.1 53.4 53.2 53.7 54.6
617 years . . . . . . . . . . . . . . . . . . . 74.9 68.5 68.5 64.7 57.2 55.8 56.0 55.4 56.2
1864 years . . . . . . . . . . . . . . . . . . . . 78.6 72.7 73.5 70.7 64.7 65.1 65.1 67.4 69.7
1844 years . . . . . . . . . . . . . . . . . . . 76.5 69.4 70.5 66.6 60.0 61.4 61.8 64.3 66.8
1824 years . . . . . . . . . . . . . . . . . 67.4 59.3 60.3 58.0 52.3 58.1 59.0 62.0 64.8
1925 years . . . . . . . . . . . . . . . . . 67.4 58.3 59.1 56.3 51.8 58.1 58.9 62.2 65.5
2534 years . . . . . . . . . . . . . . . . . 77.4 68.1 70.1 65.1 58.7 58.7 59.0 62.0 65.1
3544 years . . . . . . . . . . . . . . . . . 83.9 76.4 77.0 73.7 66.9 66.7 67.0 68.6 70.0
4564 years . . . . . . . . . . . . . . . . . . . 83.3 79.0 78.7 76.9 71.3 70.0 69.5 71.7 73.6
4554 years . . . . . . . . . . . . . . . . . 83.3 80.4 80.0 77.4 70.9 69.6 69.8 71.6 74.1
5564 years . . . . . . . . . . . . . . . . . 83.3 76.9 76.7 76.2 71.8 70.4 69.1 71.7 73.1
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . 77.3 70.9 71.6 68.0 61.1 61.8 61.9 63.8 65.4
Female. . . . . . . . . . . . . . . . . . . . . . . 76.2 70.5 71.3 68.4 62.4 61.9 61.7 63.5 65.6
Sex and marital status 5
Male:
Married . . . . . . . . . . . . . . . . . . . . . 85.0 81.6 81.5 79.6 75.1 74.9 74.8 77.1 78.3
Divorced, separated, widowed . . . . . . . . . 65.5 59.9 62.2 56.7 50.6 51.0 50.9 54.0 56.6
Never married. . . . . . . . . . . . . . . . . . 71.3 63.3 63.8 60.2 52.5 54.7 55.8 58.2 60.6
Female:
Married . . . . . . . . . . . . . . . . . . . . . 83.8 81.0 81.0 79.3 75.6 75.0 74.3 75.9 78.0
Divorced, separated, widowed . . . . . . . . . 63.1 59.1 63.2 59.9 53.9 51.8 52.1 55.1 58.1
Never married. . . . . . . . . . . . . . . . . . 72.2 63.8 64.2 61.5 54.1 56.2 56.2 58.4 60.4
Race 6
White only . . . . . . . . . . . . . . . . . . . . . 79.9 74.2 75.7 70.9 64.9 64.8 64.7 66.6 68.2
Black or African American only . . . . . . . . . . 58.1 54.7 55.9 52.9 44.8 45.8 45.4 47.1 50.6
American Indian or Alaska Native only . . . . . . 49.1 39.4 43.7 43.0 31.7 34.9 36.0 34.7 41.1
Asian only . . . . . . . . . . . . . . . . . . . . . 69.9 68.0 72.1 72.2 68.1 67.6 69.4 72.5 73.8
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . -- -- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . -- -- 61.4 57.6 52.4 52.9 50.0 55.4 55.3
Hispanic origin and race 6
Hispanic or Latino . . . . . . . . . . . . . . . . . 55.7 46.4 47.8 42.4 36.8 36.7 37.3 41.2 43.8
Mexican . . . . . . . . . . . . . . . . . . . . . 53.3 42.3 45.4 39.7 33.4 34.1 34.9 39.0 40.9
Puerto Rican . . . . . . . . . . . . . . . . . . 48.4 47.0 51.1 48.5 46.0 43.7 42.1 46.8 48.0
Cuban. . . . . . . . . . . . . . . . . . . . . . 72.5 71.0 63.9 58.1 53.8 49.1 45.3 56.6 61.7
Other Hispanic or Latino . . . . . . . . . . . . 61.6 49.9 50.7 45.6 40.9 39.5 41.2 43.1 47.8
Not Hispanic or Latino. . . . . . . . . . . . . . . 78.7 74.0 75.2 73.0 67.0 67.5 67.4 68.9 70.7
White only. . . . . . . . . . . . . . . . . . . . 82.4 78.1 79.5 77.3 72.0 72.6 72.4 73.7 75.2
Black or African American only . . . . . . . . . 58.2 54.9 56.0 53.1 45.1 46.4 45.7 48.0 51.2
Age and percent of poverty level 7
Under 65 years:
Below 100% . . . . . . . . . . . . . . . . . . 32.2 23.3 25.2 21.4 16.0 16.5 15.5 17.4 18.6
100%199% . . . . . . . . . . . . . . . . . . 70.3 53.5 50.1 44.7 34.8 36.7 35.1 38.2 39.8
100%133% . . . . . . . . . . . . . . . . . 59.4 39.7 39.3 36.0 24.4 26.9 25.3 26.5 30.6
134%199% . . . . . . . . . . . . . . . . . 75.2 60.1 55.3 49.4 40.3 42.4 40.8 45.1 45.1
200%399% . . . . . . . . . . . . . . . . . . 89.3 80.8 78.1 74.8 70.7 71.3 71.3 73.6 73.4
400% or more . . . . . . . . . . . . . . . . . 95.4 91.8 91.9 90.6 89.9 90.6 90.4 91.5 91.9
See footnotes at end of table.
Characteristic 1984 2 1997 2000 3 2005 2010 2012 2013 2014 2015
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . 29.6 19.3 20.3 15.0 9.8 10.0 9.3 9.5 10.6
100%199% . . . . . . . . . . . . . . . . . . 73.6 54.7 49.5 41.6 31.5 32.4 29.2 30.4 30.3
100%133% . . . . . . . . . . . . . . . . . 63.8 39.3 37.1 32.6 20.1 22.3 18.3 18.2 22.3
134%199% . . . . . . . . . . . . . . . . . 78.4 62.4 56.1 47.0 38.1 38.4 36.2 38.6 35.5
200%399% . . . . . . . . . . . . . . . . . . 91.1 83.5 80.8 76.6 72.6 72.5 71.8 73.5 71.1
400% or more . . . . . . . . . . . . . . . . . 96.2 93.3 93.0 92.5 91.2 91.2 92.3 92.5 92.7
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . 28.5 18.3 19.5 14.2 9.2 9.1 8.4 8.6 9.3
100%199% . . . . . . . . . . . . . . . . . . 73.9 54.7 49.4 41.4 31.5 32.1 28.5 30.2 30.1
100%133% . . . . . . . . . . . . . . . . . 63.9 38.7 36.8 32.0 19.9 21.6 17.8 18.2 21.9
134%199% . . . . . . . . . . . . . . . . . 78.6 62.8 56.2 47.0 38.3 38.4 35.3 38.3 35.3
200%399% . . . . . . . . . . . . . . . . . . 91.3 83.7 81.1 76.6 72.6 72.5 71.9 73.2 71.1
400% or more . . . . . . . . . . . . . . . . . 96.1 93.5 93.1 92.5 91.4 91.4 92.2 92.6 92.7
1864 years:
Below 100% . . . . . . . . . . . . . . . . . . 35.0 26.8 29.1 25.9 20.4 20.9 19.9 22.7 24.3
100%199% . . . . . . . . . . . . . . . . . . 68.3 52.8 50.5 46.5 36.4 38.9 38.2 42.1 44.6
100%133% . . . . . . . . . . . . . . . . . 56.6 40.3 40.9 38.3 26.9 29.6 29.2 31.1 35.4
134%199% . . . . . . . . . . . . . . . . . 73.3 58.6 54.9 50.7 41.3 44.2 43.2 48.2 49.8
200%399% . . . . . . . . . . . . . . . . . . 88.3 79.4 76.7 74.0 70.0 70.8 71.1 73.7 74.3
400% or more . . . . . . . . . . . . . . . . . 95.2 91.3 91.6 90.1 89.5 90.4 89.9 91.2 91.8
Disability measure
among adults 1864 years 8
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . -- 61.6 63.1 58.1 53.0 50.8 48.6 51.1 53.6
Any basic actions difficulty . . . . . . . . . . . -- 62.3 63.9 58.8 53.8 51.7 49.2 51.8 54.0
Any complex activity limitation . . . . . . . . . -- 47.9 48.4 44.0 38.6 36.0 34.8 34.7 38.3
No disability . . . . . . . . . . . . . . . . . . . . -- 77.4 77.2 73.7 69.3 70.2 70.7 72.5 75.3
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . 80.5 74.2 76.3 74.0 68.2 67.2 66.1 67.7 70.2
Midwest . . . . . . . . . . . . . . . . . . . . . . 80.6 77.1 78.8 74.6 66.7 68.4 68.0 68.7 70.1
South . . . . . . . . . . . . . . . . . . . . . . . 74.3 67.3 66.8 62.5 57.5 57.3 57.4 59.4 62.5
West . . . . . . . . . . . . . . . . . . . . . . . . 71.9 65.4 66.5 65.6 58.9 58.5 59.6 62.9 62.6
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . 77.5 71.2 72.3 69.0 62.9 63.0 63.0 64.8 66.7
Outside MSA . . . . . . . . . . . . . . . . . . . 75.2 68.4 67.8 64.6 55.1 55.3 54.7 56.2 57.8
See footnotes at end of table.
NOTES: This table includes persons who had private coverage through the workplace in addition to other types of health insurance coverage. Private health insurance
coverage is at the time of interview. The number of persons with private coverage was calculated by multiplying the percentage with private coverage by the number
of persons under age 65 in the civilian noninstitutionalized U.S. population, which was determined from the post-stratification Census control total for each survey
year. Percentages of persons with private coverage were calculated with unknown values excluded from denominators. See Appendix II, Health insurance coverage.
Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the
Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 19941996). Starting with 1997, data are from the family core and the
sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Number, in millions
Total 4
. . . . . . . . . . . . . . . . . . . . . . . 141.8 153.6 160.8 160.1 147.6 148.6 148.3 146.4 151.2
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . 69.1 66.4 67.1 63.6 56.6 56.9 56.6 56.4 57.4
Age
Under 19 years . . . . . . . . . . . . . . . . . . 66.4 62.8 63.1 58.7 50.9 50.1 49.6 49.6 49.8
Under 6 years . . . . . . . . . . . . . . . . . . 62.1 58.3 58.9 53.4 44.9 45.0 44.2 45.7 46.6
618 years . . . . . . . . . . . . . . . . . . . 68.4 64.9 64.9 61.1 53.8 52.4 52.0 51.3 51.2
Under 18 years . . . . . . . . . . . . . . . . . . 66.5 62.8 63.0 58.6 50.7 49.9 49.3 49.3 49.6
617 years . . . . . . . . . . . . . . . . . . . 68.7 65.1 65.0 61.1 53.8 52.3 51.8 51.1 51.0
1864 years . . . . . . . . . . . . . . . . . . . . 70.3 68.0 68.8 65.7 58.9 59.6 59.5 59.2 60.4
1844 years . . . . . . . . . . . . . . . . . . . 69.6 65.7 66.5 62.2 54.6 56.7 56.9 57.0 58.6
1824 years . . . . . . . . . . . . . . . . . 58.7 54.9 55.5 52.1 45.3 52.7 53.1 53.9 55.8
1925 years . . . . . . . . . . . . . . . . . 59.0 53.7 54.2 50.6 44.1 52.7 53.0 54.0 56.7
2534 years . . . . . . . . . . . . . . . . . 71.2 64.6 66.4 61.1 53.3 53.8 53.8 54.2 56.9
3544 years . . . . . . . . . . . . . . . . . 77.4 72.7 73.2 69.9 62.8 62.7 63.1 62.2 62.4
4564 years . . . . . . . . . . . . . . . . . . . 71.8 72.8 72.9 70.9 64.8 63.6 62.9 62.2 62.8
4554 years . . . . . . . . . . . . . . . . . 74.6 75.6 75.6 72.6 65.9 64.4 64.3 63.8 65.0
5564 years . . . . . . . . . . . . . . . . . 69.0 68.4 68.6 68.6 63.4 62.6 61.3 60.4 60.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . 69.8 66.7 67.3 63.6 56.1 57.1 56.9 56.9 57.6
Female. . . . . . . . . . . . . . . . . . . . . . . 68.4 66.2 66.9 63.6 57.1 56.8 56.4 56.0 57.3
Sex and marital status 5
Male:
Married . . . . . . . . . . . . . . . . . . . . . 77.9 77.4 77.5 75.3 70.1 69.9 69.8 69.6 70.3
Divorced, separated, widowed . . . . . . . . . 58.0 55.2 57.4 51.9 45.3 46.2 45.3 45.7 45.3
Never married. . . . . . . . . . . . . . . . . . 61.5 58.4 58.8 54.9 46.2 49.6 50.0 50.1 51.6
Female:
Married . . . . . . . . . . . . . . . . . . . . . 76.1 76.4 76.3 74.2 69.8 69.3 68.5 67.7 69.2
Divorced, separated, widowed . . . . . . . . . 51.9 53.8 57.8 54.3 48.1 46.3 46.3 45.8 46.2
Never married. . . . . . . . . . . . . . . . . . 63.5 59.6 60.1 56.3 48.2 50.9 50.6 50.7 51.7
Race 6
White only . . . . . . . . . . . . . . . . . . . . . 72.0 69.7 71.0 66.1 59.3 59.6 59.2 59.2 59.9
Black or African American only . . . . . . . . . . 52.4 52.6 53.4 50.6 42.3 43.2 42.9 42.0 44.8
American Indian or Alaska Native only . . . . . . 45.8 37.2 41.7 39.9 *29.4 34.0 34.2 30.9 35.9
Asian only . . . . . . . . . . . . . . . . . . . . . 59.0 61.7 65.8 64.4 60.6 60.1 61.4 61.4 62.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . -- -- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . -- -- 59.8 54.8 49.5 48.8 46.9 50.9 47.8
Hispanic origin and race 6
Hispanic or Latino . . . . . . . . . . . . . . . . . 52.0 43.9 45.3 40.0 34.6 34.6 34.9 36.5 37.4
Mexican . . . . . . . . . . . . . . . . . . . . . 50.5 40.8 43.6 37.6 31.6 32.5 32.5 35.1 36.2
Puerto Rican . . . . . . . . . . . . . . . . . . 45.9 45.1 49.4 46.2 43.6 41.6 40.8 42.6 41.6
Cuban. . . . . . . . . . . . . . . . . . . . . . 57.4 58.4 53.6 53.5 47.4 42.8 41.2 42.7 40.6
Other Hispanic or Latino . . . . . . . . . . . . 57.4 47.0 47.3 42.6 37.8 36.7 38.6 37.3 38.8
Not Hispanic or Latino. . . . . . . . . . . . . . . 70.7 69.5 70.6 68.0 61.3 62.0 61.7 61.2 62.2
White only. . . . . . . . . . . . . . . . . . . . 74.0 73.3 74.5 71.9 65.7 66.6 66.1 65.5 66.3
Black or African American only . . . . . . . . . 52.5 52.9 53.6 50.9 42.6 43.6 43.2 42.9 45.4
Age and percent of poverty level 7
Under 65 years:
Below 100% . . . . . . . . . . . . . . . . . . 24.1 20.0 21.0 17.8 12.4 13.6 12.2 12.2 12.7
100%199% . . . . . . . . . . . . . . . . . . 61.7 48.9 45.4 40.1 30.2 32.2 31.0 31.0 30.2
100%133% . . . . . . . . . . . . . . . . . 50.0 35.4 35.0 31.3 20.6 23.0 21.7 20.5 22.7
134%199% . . . . . . . . . . . . . . . . . 66.9 55.4 50.5 44.8 35.3 37.5 36.3 37.3 34.5
200%399% . . . . . . . . . . . . . . . . . . 82.8 76.5 73.4 69.8 65.3 65.9 65.6 65.4 64.0
400% or more . . . . . . . . . . . . . . . . . 88.8 87.4 87.9 86.1 84.2 85.1 84.6 84.5 84.8
See footnotes at end of table.
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . 23.6 17.0 17.1 13.3 8.2 8.7 7.8 7.2 7.8
100%199% . . . . . . . . . . . . . . . . . . 67.0 51.2 45.8 38.3 28.8 29.7 26.6 26.8 26.1
100%133% . . . . . . . . . . . . . . . . . 56.1 35.8 33.6 29.1 17.9 20.5 16.4 15.6 19.7
134%199% . . . . . . . . . . . . . . . . . 72.3 59.0 52.2 43.7 35.1 35.2 33.1 34.4 30.3
200%399% . . . . . . . . . . . . . . . . . . 85.7 80.0 76.9 72.4 68.7 68.0 66.7 67.6 64.4
400% or more . . . . . . . . . . . . . . . . . 90.8 89.7 89.5 88.3 86.5 86.3 86.9 87.1 86.9
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . 23.0 16.2 16.6 12.5 7.8 8.1 7.2 6.7 6.9
100%199% . . . . . . . . . . . . . . . . . . 67.5 51.2 45.8 38.2 28.8 29.4 26.0 26.7 26.0
100%133% . . . . . . . . . . . . . . . . . 56.3 35.2 33.5 28.6 17.8 19.8 16.0 15.6 19.7
134%199% . . . . . . . . . . . . . . . . . 72.8 59.4 52.4 43.9 35.2 35.2 32.4 34.3 30.1
200%399% . . . . . . . . . . . . . . . . . . 85.9 80.2 77.1 72.4 68.7 68.1 66.8 67.5 64.4
400% or more . . . . . . . . . . . . . . . . . 90.7 89.8 89.7 88.5 86.6 86.4 86.8 87.2 87.0
1864 years:
Below 100% . . . . . . . . . . . . . . . . . . 24.8 22.7 24.0 21.2 15.4 16.9 15.2 15.6 16.3
100%199% . . . . . . . . . . . . . . . . . . 58.3 47.6 45.2 41.1 30.9 33.6 33.3 33.1 32.2
100%133% . . . . . . . . . . . . . . . . . 46.0 35.5 35.9 32.9 22.1 24.6 24.7 23.2 24.4
134%199% . . . . . . . . . . . . . . . . . 63.6 53.2 49.5 45.3 35.3 38.7 38.0 38.6 36.6
200%399% . . . . . . . . . . . . . . . . . . 81.4 74.7 71.7 68.7 63.9 65.0 65.2 64.7 63.8
400% or more . . . . . . . . . . . . . . . . . 88.5 86.8 87.5 85.4 83.6 84.7 84.0 83.8 84.3
Disability measure
among adults 1864 years 8
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . -- 57.3 58.5 53.3 48.0 45.8 44.0 43.0 44.6
Any basic actions difficulty . . . . . . . . . . . -- 58.0 59.1 54.0 48.9 46.7 44.6 43.8 45.0
Any complex activity limitation . . . . . . . . . -- 43.3 43.5 38.9 32.8 30.5 29.6 26.1 29.3
No disability . . . . . . . . . . . . . . . . . . . . -- 72.5 72.5 68.5 63.5 64.7 64.7 64.2 65.8
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . 74.0 71.0 72.5 70.6 64.4 63.4 62.3 61.5 62.9
Midwest . . . . . . . . . . . . . . . . . . . . . . 72.0 72.6 74.9 70.1 61.8 63.8 62.6 61.5 62.7
South . . . . . . . . . . . . . . . . . . . . . . . 66.2 62.9 62.5 58.0 52.2 52.2 52.4 52.3 54.3
West . . . . . . . . . . . . . . . . . . . . . . . . 64.7 60.7 61.1 59.7 52.7 52.8 53.6 54.7 53.5
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . 70.9 67.3 68.2 64.5 57.9 58.1 57.8 57.8 58.6
Outside MSA . . . . . . . . . . . . . . . . . . . 65.3 62.8 62.6 59.6 49.4 50.3 49.4 48.0 50.0
See footnotes at end of table.
NOTES: This table includes persons who had private coverage through the workplace in addition to other types of health insurance coverage. Private coverage through
the workplace is at the time of interview. The number of persons with private coverage through the workplace was calculated by multiplying the percentage with private
coverage through the workplace by the number of persons under age 65 in the civilian noninstitutionalized U.S. population, which was determined from the post-
stratification Census control total for each survey year. Percentages of persons with private coverage obtained through the workplace were calculated with unknown
values excluded from denominators. See Appendix II, Health insurance coverage. Standard errors are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 19941996). Starting with 1997, data are from the family core and the
sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1984 1 1997 2000 2 2005 3 2010 3 2012 3 2013 3 2014 3 2015 3
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . 14.0 22.9 23.2 33.2 44.8 48.1 48.5 52.6 55.4
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . 6.8 9.7 9.5 12.9 16.9 18.0 18.1 19.6 20.6
Age
Under 19 years . . . . . . . . . . . . . . . . . . 11.7 18.0 19.2 26.6 35.7 38.1 38.1 38.6 39.2
Under 6 years . . . . . . . . . . . . . . . . . . 15.5 24.7 24.7 34.0 43.7 45.7 45.9 43.8 44.2
618 years . . . . . . . . . . . . . . . . . . . 9.8 14.9 16.8 23.3 31.8 34.7 34.6 36.3 36.9
Under 18 years . . . . . . . . . . . . . . . . . . 11.9 18.4 19.6 27.2 36.4 38.9 38.9 39.4 39.9
617 years . . . . . . . . . . . . . . . . . . . 10.1 15.2 17.2 23.9 32.5 35.5 35.5 37.3 37.9
1864 years . . . . . . . . . . . . . . . . . . . . 4.5 5.9 5.2 7.2 9.2 10.0 10.2 12.1 13.2
1844 years . . . . . . . . . . . . . . . . . . . 5.1 6.6 5.6 8.3 10.9 11.6 11.6 13.8 15.0
1824 years . . . . . . . . . . . . . . . . . 6.4 8.8 8.1 11.3 14.5 15.4 14.2 17.9 18.5
1925 years . . . . . . . . . . . . . . . . . 6.3 8.5 7.3 10.3 12.6 13.4 12.1 16.1 16.3
2534 years . . . . . . . . . . . . . . . . . 5.3 6.8 5.5 8.0 11.1 11.4 11.7 13.3 14.7
3544 years . . . . . . . . . . . . . . . . . 3.5 5.2 4.3 6.6 8.1 8.8 9.6 11.3 12.8
4564 years . . . . . . . . . . . . . . . . . . . 3.4 4.6 4.5 5.5 6.8 8.0 8.4 9.9 10.8
4554 years . . . . . . . . . . . . . . . . . 3.2 4.0 4.2 5.2 7.0 8.2 8.6 9.8 11.2
5564 years . . . . . . . . . . . . . . . . . 3.6 5.6 4.9 5.8 6.6 7.7 8.2 9.9 10.4
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . 5.4 8.4 8.2 11.6 15.2 16.3 16.5 17.8 19.1
Female. . . . . . . . . . . . . . . . . . . . . . . 8.1 11.1 10.8 14.3 18.5 19.7 19.8 21.4 22.0
Sex and marital status 5
Male:
Married . . . . . . . . . . . . . . . . . . . . . 1.9 2.5 2.2 3.5 4.0 4.8 5.3 6.2 7.0
Divorced, separated, widowed . . . . . . . . . 4.9 5.7 6.1 7.0 9.3 9.7 10.3 12.0 12.6
Never married. . . . . . . . . . . . . . . . . . 4.8 7.0 7.2 10.4 13.5 15.1 14.8 17.6 19.6
Female:
Married . . . . . . . . . . . . . . . . . . . . . 2.6 3.5 3.1 4.7 5.7 6.2 6.9 8.1 8.8
Divorced, separated, widowed . . . . . . . . . 16.0 14.7 12.7 14.6 17.6 18.8 18.8 21.6 23.3
Never married. . . . . . . . . . . . . . . . . . 10.7 14.2 13.2 17.3 22.2 22.6 22.2 24.9 25.7
Race 6
White only . . . . . . . . . . . . . . . . . . . . . 4.6 7.4 7.1 11.0 14.5 15.5 15.6 16.9 17.9
Black or African American only . . . . . . . . . . 20.5 22.4 21.2 24.9 30.4 31.6 31.6 34.1 34.3
American Indian or Alaska Native only . . . . . . *28.2 19.6 15.1 24.2 21.6 36.5 32.0 35.5 34.3
Asian only . . . . . . . . . . . . . . . . . . . . . *8.7 9.6 7.5 8.2 12.0 13.0 13.2 14.7 16.5
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . -- -- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . -- -- 19.1 22.0 27.4 29.1 30.4 30.2 31.5
Hispanic origin and race 6
Hispanic or Latino . . . . . . . . . . . . . . . . . 13.3 17.6 15.5 22.9 28.6 30.5 29.5 31.3 33.5
Mexican . . . . . . . . . . . . . . . . . . . . . 12.2 17.2 14.0 23.0 29.5 31.0 29.8 32.1 34.2
Puerto Rican . . . . . . . . . . . . . . . . . . 31.5 31.0 29.4 31.9 35.7 35.3 36.9 35.7 38.9
Cuban. . . . . . . . . . . . . . . . . . . . . . *4.8 7.3 9.2 17.7 17.3 22.9 23.3 22.4 22.8
Other Hispanic or Latino . . . . . . . . . . . . 7.9 15.3 14.5 19.7 24.5 28.3 27.0 28.6 30.7
Not Hispanic or Latino. . . . . . . . . . . . . . . 6.2 8.7 8.5 11.1 14.4 15.2 15.5 16.9 17.5
White only. . . . . . . . . . . . . . . . . . . . 3.7 6.1 6.1 8.5 11.0 11.5 11.9 13.0 13.6
Black or African American only . . . . . . . . . 20.7 22.1 21.0 24.8 30.0 31.3 31.3 33.4 33.6
Age and percent of poverty level 7
Under 65 years:
Below 100% . . . . . . . . . . . . . . . . . . 33.0 40.5 38.4 45.7 50.8 52.5 53.7 56.5 60.6
100%199% . . . . . . . . . . . . . . . . . . 5.3 13.0 16.2 23.4 28.5 30.1 30.8 34.0 38.1
100%133% . . . . . . . . . . . . . . . . . 8.7 20.1 22.4 30.6 36.3 38.0 38.8 43.9 47.6
134%199% . . . . . . . . . . . . . . . . . 3.7 9.5 13.1 19.5 24.4 25.5 26.2 28.1 32.6
200%399% . . . . . . . . . . . . . . . . . . 0.8 2.7 4.0 6.6 8.4 9.0 9.0 9.9 11.3
400% or more . . . . . . . . . . . . . . . . . 0.2 0.8 0.9 1.5 2.0 1.7 1.9 2.2 2.2
See footnotes at end of table.
Characteristic 1984 1 1997 2000 2 2005 3 2010 3 2012 3 2013 3 2014 3 2015 3
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . 42.0 56.4 56.9 69.4 78.4 82.1 82.1 83.3 84.8
100%199% . . . . . . . . . . . . . . . . . . 6.5 20.3 27.8 41.7 53.5 56.3 58.9 59.1 61.9
100%133% . . . . . . . . . . . . . . . . . 10.3 31.1 36.4 51.0 63.5 68.8 70.3 71.7 70.9
134%199% . . . . . . . . . . . . . . . . . 4.7 14.8 23.3 36.2 47.7 48.8 51.6 50.6 55.9
200%399% . . . . . . . . . . . . . . . . . . 1.0 4.4 7.6 13.0 17.7 18.8 19.1 18.5 20.9
400% or more . . . . . . . . . . . . . . . . . * 1.3 2.1 2.9 4.3 3.6 3.2 3.8 4.3
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . 43.3 58.0 58.5 71.2 79.8 83.7 83.9 84.7 86.7
100%199% . . . . . . . . . . . . . . . . . . 6.6 20.8 28.4 42.5 54.3 57.3 60.1 60.0 62.6
100%133% . . . . . . . . . . . . . . . . . 10.4 32.0 36.9 52.0 64.6 70.1 71.2 72.3 72.0
134%199% . . . . . . . . . . . . . . . . . 4.8 15.1 23.8 36.9 48.2 49.6 52.9 51.6 56.5
200%399% . . . . . . . . . . . . . . . . . . 1.0 4.5 7.6 13.3 18.0 19.1 19.5 18.9 21.2
400% or more . . . . . . . . . . . . . . . . . * 1.3 2.2 2.9 4.3 3.6 3.3 4.0 4.3
1864 years:
Below 100% . . . . . . . . . . . . . . . . . . 25.3 28.0 24.9 29.6 32.4 34.0 35.4 39.7 44.8
100%199% . . . . . . . . . . . . . . . . . . 4.5 8.6 9.1 13.1 15.7 16.8 17.1 21.4 25.9
100%133% . . . . . . . . . . . . . . . . . 7.6 13.0 13.2 17.9 21.0 21.8 22.0 28.3 34.2
134%199% . . . . . . . . . . . . . . . . . 3.1 6.5 7.2 10.7 13.0 13.9 14.4 17.6 21.3
200%399% . . . . . . . . . . . . . . . . . . 0.7 1.9 2.4 3.8 4.8 5.1 5.1 6.7 7.6
400% or more . . . . . . . . . . . . . . . . . 0.2 0.7 0.6 1.1 1.3 1.2 1.6 1.7 1.7
Disability measure
among adults 1864 years 8
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . -- 13.2 12.8 16.4 17.8 19.3 21.1 22.9 25.1
Any basic actions difficulty . . . . . . . . . . . -- 12.7 12.2 15.5 16.7 18.4 20.6 22.0 24.6
Any complex activity limitation . . . . . . . . . -- 22.9 23.2 28.5 30.0 30.8 32.3 35.6 36.9
No disability . . . . . . . . . . . . . . . . . . . . -- 3.5 3.0 4.9 6.8 7.0 6.8 8.7 9.2
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . 8.6 11.3 10.6 13.3 17.9 19.3 20.8 21.4 21.6
Midwest . . . . . . . . . . . . . . . . . . . . . . 7.4 8.4 8.0 12.3 17.3 16.3 16.9 18.6 19.8
South . . . . . . . . . . . . . . . . . . . . . . . 5.1 8.7 9.4 12.7 16.0 17.8 17.8 18.7 18.4
West . . . . . . . . . . . . . . . . . . . . . . . . 7.0 11.7 10.4 13.8 17.1 19.1 18.0 20.9 24.0
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . 7.1 9.7 8.9 12.4 16.1 17.4 17.4 18.9 19.8
Outside MSA . . . . . . . . . . . . . . . . . . . 6.1 10.1 11.9 15.5 21.4 21.4 22.5 24.4 25.4
See footnotes at end of table.
without and with the additional information from this question in the columns labeled 2004(1) and 2004(2) (in spreadsheet version), respectively, and estimates were
4
Includes all other races not shown separately, those with unknown marital status, unknown disability status, and, in 1984 and 1989, persons with unknown poverty level.
5
Includes persons aged 1464.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for
10%11% of persons under age 65 in 1984 and 1989. Missing family income data were imputed for 1995 and beyond. See Appendix II, Family income; Poverty;
Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: The category Medicaid coverage includes persons who had any of the following at the time of interview: Medicaid, other public assistance through 1996,
state-sponsored health plan starting in 1997, or Children's Health Insurance Program (CHIP) starting in 1999; it includes those who also had another type of coverage
in addition to one of these. In 2015, 18.4% of persons under age 65 reported being covered by Medicaid, 1.1% by state-sponsored health plans, and 1.1% by CHIP.
Estimates may not sum to total because of rounding. The number of persons with Medicaid coverage was calculated by multiplying the percentage with Medicaid
coverage by the number of persons under age 65 in the civilian noninstitutionalized U.S. population, which was determined from the post-stratification Census control
total for each survey year. Percentages of persons with Medicaid coverage were calculated with unknown values excluded from denominators. See Appendix II,
Health insurance coverage; Medicaid. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 19941996). Starting with 1997, data are from the family core and the
sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1984 1 1997 2000 2 2005 3 2010 3 2012 3 2013 3 2014 3 2015 3
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.8 41.0 41.4 42.1 48.3 45.2 44.6 35.7 28.7
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.5 17.5 17.0 16.4 18.2 16.9 16.7 13.3 10.6
Age
Under 19 years . . . . . . . . . . . . . . . . . . . . . 14.1 14.4 12.9 9.7 8.3 7.0 7.1 5.7 4.8
Under 6 years . . . . . . . . . . . . . . . . . . . . 14.9 12.5 11.8 7.7 6.3 4.6 5.0 4.1 3.3
618 years . . . . . . . . . . . . . . . . . . . . . . 13.8 15.2 13.4 10.6 9.2 8.1 8.0 6.5 5.5
Under 18 years . . . . . . . . . . . . . . . . . . . . . 13.9 14.0 12.6 9.3 7.8 6.6 6.6 5.4 4.5
617 years . . . . . . . . . . . . . . . . . . . . . . 13.4 14.7 13.0 10.1 8.6 7.6 7.4 6.1 5.1
1864 years . . . . . . . . . . . . . . . . . . . . . . . 14.8 19.0 18.9 19.3 22.3 20.9 20.5 16.3 13.0
1844 years . . . . . . . . . . . . . . . . . . . . . . 17.1 22.4 22.4 23.5 27.1 24.8 24.2 19.7 15.9
1824 years . . . . . . . . . . . . . . . . . . . . 25.0 30.1 30.4 29.1 31.4 24.5 24.6 18.1 14.6
1925 years . . . . . . . . . . . . . . . . . . . . 25.1 31.5 32.3 31.7 33.8 26.3 26.7 19.7 16.0
2534 years . . . . . . . . . . . . . . . . . . . . 16.2 23.8 23.3 25.6 28.3 28.1 27.1 22.7 18.0
3544 years . . . . . . . . . . . . . . . . . . . . 11.2 16.7 16.9 17.9 22.6 21.7 21.0 17.7 14.6
4564 years . . . . . . . . . . . . . . . . . . . . . . 9.6 12.4 12.6 12.9 15.7 15.6 15.4 11.8 9.0
4554 years . . . . . . . . . . . . . . . . . . . . 10.5 12.8 12.8 14.2 17.9 17.7 17.1 13.7 10.2
5564 years . . . . . . . . . . . . . . . . . . . . 8.7 11.8 12.4 11.1 12.8 13.2 13.5 9.7 7.7
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 18.7 18.1 17.9 20.3 18.5 18.1 14.7 12.0
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 13.8 16.3 15.9 15.0 16.1 15.4 15.2 11.9 9.3
Sex and marital status 5
Male:
Married . . . . . . . . . . . . . . . . . . . . . . . . 11.1 13.9 14.1 14.4 17.2 16.2 15.9 12.6 10.6
Divorced, separated, widowed . . . . . . . . . . 24.9 28.8 25.8 28.6 31.4 29.3 28.1 23.2 20.0
Never married . . . . . . . . . . . . . . . . . . . . 22.4 27.9 27.2 27.6 31.1 27.5 26.9 21.9 17.4
Female:
Married . . . . . . . . . . . . . . . . . . . . . . . . 11.2 13.0 13.3 13.0 14.7 14.6 14.6 11.6 8.8
Divorced, separated, widowed . . . . . . . . . . 19.2 23.2 21.3 22.1 23.6 24.2 22.8 17.7 13.4
Never married . . . . . . . . . . . . . . . . . . . . 16.3 20.5 21.1 20.0 21.9 19.6 19.6 15.1 12.1
Race 6
White only . . . . . . . . . . . . . . . . . . . . . . . . 13.6 16.4 15.4 15.9 17.6 16.7 16.3 13.3 10.7
Black or African American only . . . . . . . . . . . . 19.9 20.1 19.5 18.4 20.6 18.0 18.9 13.7 11.3
American Indian or Alaska Native only . . . . . . . 22.5 38.1 38.4 32.2 44.0 27.0 29.4 28.3 21.4
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 18.5 19.5 17.6 17.1 17.1 16.8 14.2 10.8 7.5
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . . . . . -- -- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . . . . . -- -- 16.8 16.5 15.8 14.5 15.3 10.1 9.5
Hispanic origin and race 6
Hispanic or Latino . . . . . . . . . . . . . . . . . . . 29.5 34.5 35.6 33.0 32.0 30.4 30.7 25.5 21.1
Mexican . . . . . . . . . . . . . . . . . . . . . . . . 33.8 39.4 39.9 36.0 34.8 33.2 33.4 27.2 23.5
Puerto Rican . . . . . . . . . . . . . . . . . . . . . 18.3 19.0 16.4 16.3 13.7 14.4 15.6 13.0 9.6
Cuban . . . . . . . . . . . . . . . . . . . . . . . . . 21.6 21.1 25.4 23.2 26.5 24.3 26.6 19.4 14.2
Other Hispanic or Latino . . . . . . . . . . . . . . 27.4 33.0 33.4 32.6 32.4 30.1 28.8 26.2 19.7
Not Hispanic or Latino . . . . . . . . . . . . . . . . . 13.2 15.2 14.0 13.4 15.2 13.9 13.4 10.5 8.2
White only. . . . . . . . . . . . . . . . . . . . . . . 11.9 13.8 12.5 12.0 13.7 12.7 12.2 9.7 7.5
Black or African American only . . . . . . . . . . 19.7 20.0 19.5 18.3 20.7 17.8 18.8 13.5 11.2
Age and percent of poverty level 7
Under 65 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 33.9 33.7 34.2 30.6 30.3 28.2 28.0 23.0 18.2
100%199% . . . . . . . . . . . . . . . . . . . . . 21.8 30.6 31.0 28.6 32.4 29.3 29.3 23.4 18.3
100%133% . . . . . . . . . . . . . . . . . . . 28.8 36.6 35.7 30.1 34.9 31.1 30.4 25.0 18.4
134%199% . . . . . . . . . . . . . . . . . . . 18.7 27.7 28.7 27.8 31.0 28.4 28.6 22.4 18.1
200%399% . . . . . . . . . . . . . . . . . . . . . 7.6 14.2 15.4 15.7 17.4 16.2 16.1 12.6 11.1
400% or more . . . . . . . . . . . . . . . . . . . . 3.2 6.1 5.9 6.3 5.6 4.9 4.8 3.8 3.3
See footnotes at end of table.
Characteristic 1984 1 1997 2000 2 2005 3 2010 3 2012 3 2013 3 2014 3 2015 3
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 29.0 23.8 22.6 15.2 11.3 8.3 8.9 6.7 5.4
100%199% . . . . . . . . . . . . . . . . . . . . . 18.0 23.7 22.1 15.6 13.5 11.1 11.7 9.3 7.4
100%133% . . . . . . . . . . . . . . . . . . . 24.4 28.2 26.5 15.6 15.9 9.6 11.6 9.4 7.7
134%199% . . . . . . . . . . . . . . . . . . . 14.9 21.4 19.7 15.6 12.0 12.0 11.7 9.3 7.2
200%399% . . . . . . . . . . . . . . . . . . . . . 5.1 9.7 9.6 8.2 7.4 6.8 6.7 5.7 5.4
400% or more . . . . . . . . . . . . . . . . . . . . 1.8 4.0 3.5 3.3 2.3 2.2 1.9 1.7 1.6
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 28.9 23.2 22.0 14.3 10.6 7.6 8.2 6.4 4.9
100%199% . . . . . . . . . . . . . . . . . . . . . 17.5 23.2 21.7 15.0 12.7 10.4 11.1 8.7 6.9
100%133% . . . . . . . . . . . . . . . . . . . 24.0 28.1 26.4 15.1 15.1 9.0 11.2 8.9 7.3
134%199% . . . . . . . . . . . . . . . . . . . 14.4 20.7 19.1 15.0 11.3 11.3 11.1 8.5 6.7
200%399% . . . . . . . . . . . . . . . . . . . . . 4.9 9.4 9.3 7.8 7.0 6.7 6.3 5.5 5.2
400% or more . . . . . . . . . . . . . . . . . . . . 1.8 3.9 3.3 3.2 2.1 2.1 1.8 *1.6 1.6
1864 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 37.6 41.2 42.4 40.9 42.7 40.5 40.0 32.9 26.2
100%199% . . . . . . . . . . . . . . . . . . . . . 24.4 34.7 36.4 35.9 42.1 38.6 37.8 30.5 23.9
100%133% . . . . . . . . . . . . . . . . . . . 31.9 41.7 41.7 38.9 45.7 42.2 40.4 33.9 24.5
134%199% . . . . . . . . . . . . . . . . . . . 21.1 31.5 34.0 34.4 40.3 36.5 36.4 28.7 23.6
200%399% . . . . . . . . . . . . . . . . . . . . . 8.9 16.4 18.2 19.0 21.3 19.8 19.7 15.3 13.3
400% or more . . . . . . . . . . . . . . . . . . . . 3.4 6.7 6.6 7.1 6.5 5.6 5.6 4.3 3.8
Disability measure
among adults 1864 years 8
Any basic actions difficulty or complex
activity limitation. . . . . . . . . . . . . . . . . . . . -- 20.1 17.6 19.6 20.8 20.4 20.4 16.2 11.6
Any basic actions difficulty . . . . . . . . . . . . . -- 20.1 17.6 19.8 20.9 20.3 20.4 16.3 11.8
Any complex activity limitation . . . . . . . . . . -- 20.2 16.1 16.9 17.2 18.3 17.1 12.5 9.2
No disability . . . . . . . . . . . . . . . . . . . . . . . -- 17.6 18.5 19.5 21.6 20.4 19.9 16.3 13.1
Geographic region
Northeast. . . . . . . . . . . . . . . . . . . . . . . . . 10.2 13.5 12.2 11.3 12.4 11.5 11.2 9.3 6.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 13.2 12.3 11.9 14.1 13.6 13.1 10.3 8.2
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 20.9 20.5 21.0 21.9 20.3 19.9 16.9 14.2
West . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2 20.6 20.7 18.4 20.6 19.0 18.9 13.3 10.1
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . . . . 13.6 16.9 16.6 16.1 17.8 16.4 16.2 13.0 10.3
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 16.6 19.8 18.6 17.8 20.4 19.9 19.3 15.2 12.8
See footnotes at end of table.
without and with the additional information from this question in the columns labeled 2004(1) and 2004(2) (in spreadsheet version), respectively, and estimates were
4
Includes all other races not shown separately, those with unknown marital status, unknown disability status, and, in 1984 and 1989, persons with unknown poverty level.
5
Includes persons aged 1464.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories
prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003
data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for
10%11% of persons under age 65 in 1984 and 1989. Missing family income data were imputed for 1995 and beyond. See Appendix II, Family income; Poverty;
Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component
of the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Persons not covered by private insurance, Medicaid, Children's Health Insurance Program (CHIP), public assistance (through 1996), state-sponsored or other
government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health
Service coverage are considered to have no health insurance coverage. Health insurance coverage is at the time of interview. The number of persons with no health
insurance coverage was calculated by multiplying the percentage with no coverage by the number of persons under age 65 in the civilian noninstitutionalized U.S.
population, which was determined from the post-stratification Census control total for each survey year. Percentages of persons without coverage were calculated with
unknown values excluded from denominators. See Appendix II, Children's Health Insurance Program (CHIP); Health insurance coverage; Medicaid. Standard errors are
available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet
on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 19941996). Starting with 1997, data are from the family core and the
sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
1
Enrollee has a Medicare Advantage plan regardless of other insurance. Medicare Advantage plans include health maintenance organizations, preferred provider
organizations, private fee-for-service plans, special needs plans, and Medicare medical savings account plans. Starting with 2013 data, the term Medicare Risk Health
Maintenance Organization was replaced with Medicare Advantage plan. See Appendix II, Managed care.
2
Enrolled in Medicaid and not enrolled in a Medicare Advantage plan. See Appendix II, Managed care.
3
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. See Appendix II, Family
income; Poverty.
4
Private insurance plans purchased through employers (own, current, or former employer, family business, union, or former employer or union of spouse) and not
enrolled in a Medicare Advantage plan or Medicaid.
5
Supplemental insurance purchased privately or through organizations such as American Association of Retired Persons or professional organizations, and not enrolled
in a Medicare Advantage plan, Medicaid, or employer-sponsored plan.
6
Medicare fee-for-service only or other public plans (except Medicaid).
NOTES: Data for noninstitutionalized Medicare beneficiaries. Insurance categories are mutually exclusive. Persons with more than one type of coverage are categorized
according to the order in which the health insurance categories appear in the table. See Appendix I, Medicare Current Beneficiary Survey (MCBS). Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care file. See Appendix I, Medicare Current Beneficiary Survey
(MCBS).
1
Preliminary estimates.
2
Average number enrolled in the hospital insurance (HI) and/or supplementary medical insurance (SMI) programs for the period. See Appendix II, Medicare.
3
Starting with 2004 data, the SMI trust fund consists of two separate accounts: Part B (which pays for a portion of the costs of physicians' services, outpatient hospital
services, and other related medical and health services for voluntarily enrolled individuals) and Part D (Medicare Prescription Drug Account, which pays private plans to
4
The Medicare Modernization Act, enacted December 8, 2003, established within SMI two Part D accounts related to prescription drug benefits: the Medicare
Prescription Drug Account and the Transitional Assistance Account. The Medicare Prescription Drug Account is used in conjunction with the broad, voluntary
prescription drug benefits that began in 2006. The Transitional Assistance Account was used to provide transitional assistance benefits, beginning in 2004 and
extending through 2005, for certain low-income beneficiaries prior to the start of the new prescription drug benefit. The amounts shown for Total Part D expenditures
and thus for total SMI expenditures and total Medicare expendituresfor 2006 and later years include estimated amounts for premiums paid directly from Part D
5
Medicare-approved managed care organizations. See Appendix II, Managed care.
6
Includes Community-Based Care Transitions Program ($0.1 billion in each of 20112015) and Electronic Health Records Incentive Program ($0.7 billion in 2011, $2.7
billion in 2012, $3.4 billion in 2013, $3.6 billion in 2014, and $2.5 billion in 2015).
7
For 1998 to 2003, data reflects annual home health HI to SMI transfer amounts.
8
When a beneficiary chooses a Medicare Advantage plan whose monthly premium exceeds the benchmark amount, the additional premiums (that is, amounts beyond
those paid by Medicare to the plan) are the responsibility of the beneficiary. Beneficiaries subject to such premiums may choose to either reimburse the plans directly
or have the additional premiums deducted from their Social Security checks. The amounts shown here are only those additional premiums deducted from Social
Security checks. These amounts are transferred to the HI trust and SMI trust funds and then transferred from the trust funds to the plans.
9
Represents misallocation of benefit payments between the HI trust fund and the Part B account of the SMI trust fund from May 2005 to September 2007, and the
transfer made in June 2008 to correct the misallocation.
10
Includes expenditures for research, experiments and demonstration projects, peer review activity (performed by Peer Review Organizations from 1983 to 2001 and by
Quality Review Organizations from 2002 to present), and to combat and prevent fraud and abuse.
11
Type-of-service reporting categories for fee-for-service reimbursement differ before and after 1991.
12
Includes payment for physicians, practitioners, durable medical equipment, and all suppliers other than independent laboratory through 1990. Starting with 1991
data, physician services subject to the physician fee schedule are shown. Payments for laboratory services paid under the laboratory fee schedule and performed in
a physician office are included under Laboratory beginning in 1991. Payments for durable medical equipment are shown separately beginning in 1991. The remaining
services from the Physician/supplier category are included in Other.
13
Includes payments for hospital outpatient department services, skilled nursing facility outpatient services, Part B services received as an inpatient in a hospital or
skilled nursing facility setting, and other types of outpatient facilities. Starting with 1991 data, payments for hospital outpatient department services, except for
laboratory services, are listed under Hospital. Hospital outpatient laboratory services are included in the Laboratory line.
14
Starting with 1991 data, those independent laboratory services that were paid under the laboratory fee schedule (most of the independent laboratory category) are
included in the Laboratory line; the remaining services are included in the Physician fee schedule and Other lines.
15
Payments for laboratory services paid under the laboratory fee schedule performed in a physician office, independent laboratory, or in a hospital outpatient department.
16
Includes payments for physician-administered drugs; freestanding ambulatory surgical center facility services; ambulance services; supplies; freestanding end-stage
renal disease (ESRD) dialysis facility services; rural health clinics; outpatient rehabilitation facilities; psychiatric hospitals; and federally qualified health centers.
17
Includes the hospital facility costs for Medicare Part B services that are predominantly in the outpatient department, with the exception of hospital outpatient
laboratory services, which are included on the Laboratory line. Physician reimbursement is included on the Physician fee schedule line.
18
Part D start-up costs were funded through the SMI Part B account in 20042008.
NOTES: Estimates are subject to change as more recent data become available. Totals may not equal the sum of the components because of rounding. Estimates are
for Medicare-covered services furnished to Medicare enrollees residing in the United States, Puerto Rico, Virgin Islands, Guam, other outlying areas, foreign countries,
and unknown residence. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
Estimates in this table have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services (CMS), Office of the Actuary, Medicare and Medicaid Cost Estimates Group. Estimates are based on unpublished
data from CMS, the Office of the Actuary, and Treasury Department financial statements.
* Estimates are based on 50 persons or fewer or have a relative standard error of 30% or higher and are considered unreliable.
1
Physician/supplier services include medical and osteopathic doctor and health practitioner visits, diagnostic laboratory and radiology services, medical and surgical
services, and durable medical equipment and nondurable medical supplies.
2
Total health care expenditures by Medicare beneficiaries. Includes expenses paid by Medicare and all other sources of payment for the following services:
inpatient hospital, outpatient hospital, physician/supplier, dental, prescription medicine, home health, and hospice and long-term care facility care. Excludes health
insurance premiums.
3
Expenditures for long-term care in facilities for all beneficiaries. Includes facility room and board expenses for beneficiaries who resided in a facility for the full year and
for beneficiaries who resided in a facility for part of the year and in the community for part of the year. Also includes expenditures for short-term facility stays for full-
year or part-year community residents. See Appendix II, Long-term care facility.
4
Expenditures for facility-based long-term care for facility-based beneficiaries. Includes facility room and board expenses for beneficiaries who resided in a facility for
the full year and for beneficiaries who resided in a facility for part of the year and in the community for part of the year. Excludes expenditures for short-term facility
stays for full-year community residents. See Appendix II, Long-term care facility.
5
Medicare beneficiaries with end-stage renal disease (ESRD) are included within the subgroups Aged and Disabled. In 2013, less than 1% of Medicare beneficiaries
qualified because of ESRD. See Appendix II, Medicare.
6
In 2013, less than 1% of Medicare beneficiaries had an unknown living arrangement.
7
IADL is instrumental activities of daily living; ADL is activities of daily living. Includes data for both community and long-term care facility residents. See Appendix II,
Activities of daily living (ADL); Instrumental activities of daily living (IADL).
NOTES: Percentages and percent distributions are calculated using unrounded numbers. Expenditures include expenses for Medicare beneficiaries paid by Medicare
and all other sources of payment. Estimates include individuals enrolled in the hospital insurance (HI) and/or supplementary medical insurance (SMI) programs at any
time during the calendar year. A new imputation methodology was used starting with 2012 estimates; therefore some utilization estimates may not be comparable to
previous years.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use file, Health and Health Care of the Medicare Population.
Available from: http://www.cms.hhs.gov/mcbs and unpublished data. See Appendix I, Medicare Current Beneficiary Survey (MCBS).
1
Starting with 2011, a new tabular methodology was used. Therefore, estimates may not be comparable to earlier data and caution should be used with trend analysis.
2
Beneficiaries include those who were enrolled or received services through Medicaid or the Children's Health Insurance Program (CHIP). Beneficiary counts for 2011
and subsequent years were derived from MSIS claims files. Separate CHIP beneficiaries are included for 2011 and subsequent years.
3
Includes adults who meet the requirements for the Aid to Families with Dependent Children (AFDC) program that were in effect in their state on July 16, 1996, or,
at state option, meet more liberal criteria (with some exceptions). Includes adults in the Temporary Assistance for Needy Families (TANF) program. Starting with
2001 data, includes women in the Breast and Cervical Cancer Prevention and Treatment Program and unemployed adults. For more information on the eligibility
requirements, see Appendix II, Medicaid.
4
Includes children (including those in the foster care system) in the TANF program. For more information on the eligibility requirements, see Appendix II, Medicaid.
5
Includes some participants in the Supplemental Security Income program and other people deemed medically needy in participating states. Excludes foster care
children and includes unknown eligibility. Prior to 2001, includes unemployed adults.
6
CHIP is Children's Health Insurance Program. CHIP provides federal funds for states to provide health care coverage to eligible low-income, uninsured children who do
not qualify for Medicaid. Some states use CHIP funds to expand Medicaid. For 2012 data, all states except Colorado and Idaho had separate CHIP beneficiaries. See
Appendix II, Children's Health Insurance Program (CHIP).
7
Race and Hispanic origin are as determined based on the last best eligibility record of the beneficiary. Categories are mutually exclusive. Starting with 2001 data,
the Hispanic category included Hispanic persons, regardless of race. Persons indicating more than one race or missing race information were included in the
multiple race category.
8
Payments for 2011 and subsequent years were derived from MSIS claims files. Medicaid payment data for 2010 and earlier excluded disproportionate share hospital
(DSH) payments ($14.7 billion in FY2010) and DSH mental health facility payments ($2.9 billion in FY2010).
NOTES: Data are for fiscal year ending September 30. See Appendix II, Medicaid; Medicaid payments. For more information, see: http://www.medicaid.gov. Colorado
and Idaho had not reported 2012 data as of the date 2012 data were accessed. Colorado, District of Columbia, Idaho, and Rhode Island had not reported 2013 data
and Kansas had only reported partial 2013 data as of the date accessed. For more information on data quality and analytic issues, see:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Tables.html.
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Medicaid Statistical Information System (MSIS), granular file. MSIS data
for 2013 were accessed October 5, 2016. See Appendix I, Medicaid Statistical Information System (MSIS).
Type of service 1999 2000 2005 2008 2009 2010 2011 1 2012 1 2013 1
Type of service 1999 2000 2005 2008 2009 2010 2011 1 2012 1 2013 1
1
Starting with 2011, a new tabular methodology was used. Therefore, estimates may not be comparable to earlier data and caution should be used with trend analysis.
2
Beneficiaries include those who were enrolled or received services through Medicaid or the Children's Health Insurance Program (CHIP). Separate CHIP beneficiaries
are included for 2011 and subsequent years.
3
This category was previously known as Intermediate care facility for the mentally retarded. This is a change in terminology only and not measurement.
4
Estimates for 2010 and earlier include unknown services and payments with Other care.
5
Medicaid payment data for 2010 and earlier exclude disproportionate share hospital (DSH) payments ($14.7 billion in FY2010) and DSH mental health facility payments
($2.9 billion in FY2010).
NOTES: Data are for fiscal year ending September 30. See Appendix II, Medicaid; Medicaid payments. Beneficiaries receiving more than one type of service appear
in multiple categories. Therefore, percents may not add up to 100%. For more information, see: http://www.medicaid.gov. Colorado and Idaho had not reported 2012
data as of the date 2012 data were accessed. Colorado, District of Columbia, Idaho, and Rhode Island had not reported 2013 data and Kansas had only reported
partial 2013 data as of the date accessed. For more information on data quality and analytic issues, see: https://www.cms.gov/Research-Statistics-Data-and-Systems/
Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Tables.html.
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Medicaid Statistical Information System (MSIS), granular file. MSIS data
for 2013 were accessed October 5, 2016. See Appendix I, Medicaid Statistical Information System (MSIS).
Type of expenditure and use 2005 2008 2009 2010 2011 2012 2013 2014 2015
1
Health care expenditures exclude construction, medical administration, and miscellaneous operating expenses at Department of Veterans Affairs (VA) headquarters.
2
Includes expenditures for miscellaneous benefits and services, contract hospitals, education and training, subsidies to state veterans hospitals, nursing homes and
residential rehabilitation treatment programs (formerly domiciliaries), and the Civilian Health and Medical Program of the Department of Veterans Affairs.
3
Discharges from medicine, surgery, psychiatry, rehabilitation medicine, spinal cord, and neurology units, and residential rehabilitation treatment programs (formerly,
domiciliary care). Does not include long-term stays.
4
Hospital outpatient care. Includes the following services: physicians, laboratory tests, home-based primary care, or outpatient fee-basis care.
5
Includes VA-covered state nursing home veteran patients.
6
Individuals receiving services. Individuals with multiple discharges or visits are only counted once in the inpatient or outpatient category. The inpatient and outpatient
totals are not additive because most inpatients are also treated as outpatients.
7
Includes veterans who receive medical care subject to copayments according to income level, based on financial means testing.
8
Includes expenditures for services for veterans who were prisoners of war, exposed to Agent Orange, and other. Veterans reporting Agent Orange exposure but not
treated for it were means tested and placed in the low income or other group depending on income.
NOTES: Some veterans have multiple sources of health coverage, including Medicare or private insurance. Estimates in this table relate only to health care use paid for
by the Veteran's Administration. At the end of FY2015, the veteran population was estimated at 21.7 million, with 46% aged 65 and over. Of all living veterans, 4% had
served during World War II, 8% during the Korean conflict, 32% during the Vietnam era, 33% during the Persian Gulf War (service from August 2, 1990 to present), and
24% during peacetime. Percentages sum to more than 100% because some veterans serve during more than one war. See Appendix I, Department of Veterans Affairs
National Enrollment and Patient Databases. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: Department of Veterans Affairs (VA), Office of the Assistant Deputy Under Secretary for Health, National Patient Care Database, National Enrollment
Database, budgetary data, and unpublished data. Veteran population estimates were provided by the VA's Office of the Actuary. See Appendix I, Department of
Veterans Affairs National Enrollment and Patient Databases.
United States 4. . . . . . . . . . . . 36,190 54,286 7.9 31.3 $4,375 $9,635 345 282 7.5 5.3
Alabama . . . . . . . . . . . . . . 633 968 0.8 25.3 4,454 8,611 413 313 7.0 5.5
Alaska . . . . . . . . . . . . . . . 33 84 0.6 1.0 3,687 8,301 269 181 6.3 6.0
Arizona . . . . . . . . . . . . . . 578 1,140 24.8 38.1 4,442 8,728 292 228 5.9 4.9
Arkansas . . . . . . . . . . . . . 416 594 0.2 20.1 3,719 8,360 366 288 7.0 5.3
California . . . . . . . . . . . . . 3,582 5,645 30.0 40.5 5,219 10,294 366 242 6.1 5.4
Colorado . . . . . . . . . . . . . 413 786 17.2 36.9 3,935 7,914 302 218 6.0 4.7
Connecticut. . . . . . . . . . . . 497 630 2.6 25.6 4,426 10,636 287 293 8.1 5.7
Delaware . . . . . . . . . . . . . 99 181 0.2 8.3 4,712 9,803 326 278 8.1 5.5
District of Columbia . . . . . . . 80 88 3.9 13.1 5,655 10,058 376 320 10.1 6.3
Florida . . . . . . . . . . . . . . . 2,584 4,040 13.8 39.8 5,027 10,715 326 324 7.1 5.3
Georgia . . . . . . . . . . . . . . 819 1,521 0.4 31.5 4,402 9,042 378 275 6.9 5.4
Hawaii . . . . . . . . . . . . . . . 146 244 29.8 45.8 3,069 6,459 301 162 9.1 6.4
Idaho. . . . . . . . . . . . . . . . 146 283 2.5 32.6 3,045 7,706 274 181 5.2 4.6
Illinois . . . . . . . . . . . . . . . 1,605 2,063 5.5 21.0 4,324 9,910 374 308 7.3 5.1
Indiana. . . . . . . . . . . . . . . 805 1,151 2.6 23.8 3,945 9,332 345 293 6.9 5.1
Iowa . . . . . . . . . . . . . . . . 470 572 3.1 14.9 3,080 8,286 322 235 6.6 5.1
Kansas . . . . . . . . . . . . . . 378 487 3.3 13.7 3,847 8,652 348 261 6.5 4.9
Kentucky . . . . . . . . . . . . . 578 863 2.3 26.2 3,862 9,012 396 315 7.2 5.2
Louisiana . . . . . . . . . . . . . 572 793 0.4 30.1 5,468 10,047 399 301 7.2 5.4
Maine . . . . . . . . . . . . . . . 198 306 0.1 22.9 3,464 8,232 322 218 7.6 5.3
Maryland . . . . . . . . . . . . . 596 930 1.4 8.7 4,997 11,010 362 293 7.5 5.5
Massachusetts . . . . . . . . . . 924 1,217 6.1 20.9 5,147 10,394 350 295 7.6 5.2
Michigan . . . . . . . . . . . . . 1,331 1,894 0.7 33.3 4,307 10,381 328 336 7.6 5.2
Minnesota . . . . . . . . . . . . . 625 912 19.6 53.8 3,394 12,904 334 405 5.7 4.9
Mississippi . . . . . . . . . . . . 391 560 0.1 14.7 4,189 9,659 423 319 7.4 5.6
Missouri . . . . . . . . . . . . . . 821 1,136 3.4 28.3 4,191 9,042 349 306 7.3 5.1
Montana . . . . . . . . . . . . . . 128 201 0.4 18.3 3,114 7,277 306 185 5.9 4.9
Nebraska . . . . . . . . . . . . . 247 314 2.2 12.3 2,926 8,948 281 239 6.3 5.0
Nevada . . . . . . . . . . . . . . 187 455 19.0 33.1 4,306 9,216 291 248 7.0 5.7
New Hampshire . . . . . . . . . 152 266 0.2 7.5 3,414 8,374 281 218 7.6 5.4
New Jersey . . . . . . . . . . . . 1,158 1,489 2.6 15.4 4,531 10,898 354 294 10.2 5.8
New Mexico . . . . . . . . . . . 205 373 13.6 31.7 3,110 7,680 301 208 6.0 5.0
New York . . . . . . . . . . . . . 2,601 3,339 6.2 37.0 4,855 10,572 334 290 11.2 6.7
North Carolina . . . . . . . . . . 1,001 1,771 0.5 29.8 3,465 8,858 314 277 8.0 5.3
North Dakota . . . . . . . . . . . 101 119 0.6 16.9 3,218 8,723 327 247 6.3 5.4
Ohio . . . . . . . . . . . . . . . . 1,649 2,153 2.4 41.0 3,982 9,613 350 309 7.1 5.0
Oklahoma . . . . . . . . . . . . . 481 679 2.5 16.9 4,098 9,348 355 295 7.0 5.3
Oregon . . . . . . . . . . . . . . 469 756 27.7 43.8 3,285 7,842 305 191 5.2 4.8
Pennsylvania . . . . . . . . . . . 2,053 2,531 3.3 39.9 5,212 9,687 379 304 8.0 5.3
Rhode Island . . . . . . . . . . . 166 203 7.0 35.1 4,148 9,224 312 296 8.1 5.3
South Carolina . . . . . . . . . . 497 943 0.1 23.2 3,777 8,635 319 265 8.3 5.4
South Dakota . . . . . . . . . . . 114 156 0.1 19.0 2,952 8,969 356 258 6.1 4.9
Tennessee . . . . . . . . . . . . 754 1,236 0.3 34.3 4,441 8,963 375 300 7.1 5.3
Texas . . . . . . . . . . . . . . . 2,029 3,636 4.1 31.8 4,703 10,603 333 289 7.2 5.3
Utah . . . . . . . . . . . . . . . . 182 346 9.4 33.8 3,443 8,187 238 207 5.4 4.3
Vermont . . . . . . . . . . . . . . 82 131 0.1 7.5 3,182 7,917 283 179 7.6 5.5
Virginia . . . . . . . . . . . . . . 803 1,349 1.5 18.1 3,748 8,280 348 273 7.3 5.1
Washington . . . . . . . . . . . . 676 1,192 12.5 30.0 3,401 7,920 269 207 5.3 4.9
West Virginia . . . . . . . . . . . 326 416 8.3 26.8 3,798 8,641 420 312 7.1 5.4
Wisconsin . . . . . . . . . . . . . 752 1,050 2.0 37.9 3,246 8,746 310 253 6.8 4.9
Wyoming . . . . . . . . . . . . . 58 95 3.3 3.9 3,537 8,235 315 205 5.6 4.8
See footnotes at end of table.
1
Total persons enrolled in the hospital insurance (Part A) program, supplementary medical insurance (Part B) program, or both, as of July 1. Includes fee-for-service and
managed care enrollees.
2
See Appendix II, Managed care.
3
Data are for fee-for-service enrollees only.
4
Includes residents of the 50 states and the District of Columbia.
NOTES: In 1994, 92% of Medicare enrollees were in fee-for-service; in 2015, 69% of enrollees were in fee-for-service. See Appendix II, Medicare; Fee-for-service health
insurance. Prior to 2004, enrollment and percentage of enrollees in managed care were based on a 5% annual Denominator File derived from the Centers for Medicare
& Medicaid Services' (CMS) Enrollment Database. Starting with 2004 data, the enrollee counts were pulled from the 100% Denominator File. Payments per fee-for
service enrollee are based on fee-for-service billing reimbursement for a 5% sample of Medicare beneficiaries as recorded in CMS' National Claims History File. Prior
to 2011, short-stay hospital utilization is based on the Medicare Provider Analysis and Review (MedPAR) stay records for a 20% sample of Medicare beneficiaries.
Beginning in 2011, short-stay hospital utilization is based on the MedPAR stay records for 100% of Medicare beneficiaries. Estimates may not sum to totals because of
rounding. State based on residence of the beneficiary. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: Centers for Medicare & Medicaid Services; Office of Research, Development, and Information. Health Care Financing Review: Medicare and Medicaid
Statistical Supplements for publication years 1996 to 2010; Center for Strategic Planning. Medicare & Medicaid Research Review: Medicare and Medicaid Statistical
Supplement for publication year 2011; Office of Information Products and Data Analytics; Medicare and Medicaid Statistical Supplements for publication year 2012;
Data for 2013 and 2014 (shown in spreadsheet version), and 2015 are unpublished. See Appendix I, Medicare Administrative Data.
NOTES: See Appendix II, Children's Health Insurance Program (CHIP); Medicaid; Medicaid payments. Colorado and Idaho had not reported 2012 payment data as of
the date 2012 data were accessed. Colorado, District of Columbia, Idaho, and Rhode Island had not reported and Kansas had only reported partial 2013 payment data
as of the date accessed. For more information on data quality and analytic issues, see:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Tables.html.
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services, Medicaid Statistical Information System (MSIS), granular file and
Medicaid Managed Care Reports. MSIS data for 2013 were accessed October 5, 2016. See Appendix I, Medicaid Statistical Information System (MSIS).
Age, state, and territory 2009 2010 2011 2012 2013 2014 2015
Age, state, and territory 2009 2010 2011 2012 2013 2014 2015
Age, state, and territory 2009 2010 2011 2012 2013 2014 2015
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%. Data not shown have an RSE greater than 30%.
1
Excludes data for Puerto Rico.
2
Data for Puerto Rico are collected in the Puerto Rico Community Survey. Data are not collected for the other territories.
NOTES: Health insurance estimates are shown for the civilian noninstitutionalized population. Data for 2009 use Census 2000 population controls, and data for 2010
and beyond use Census 2010 population controls. Questions on health insurance coverage ask about current coverage as of the day of American Community Survey
(ACS) interview. Persons were considered uninsured if they were not covered by private health insurance, Medicare, Medicaid, Medical Assistance, TRICARE or other
military health care, veteran's coverage through the Veteran's Administration, or other government coverage. People with Indian Health Service coverage only are
considered uninsured by ACS. Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.
htm. Standard errors were computed with replicate weights using 80 balanced repeated replicate weights (BRR) with a Fay-modified BRR adjustment factor of 0.5.
SOURCE: U.S. Census Bureau, American Community Survey, public-use microdata sample. See Appendix I, American Community Survey (ACS).
(BHSUA) . . . . . . . . . . . . . . . . . . . . . . . . . . . .372
Sexually Transmitted Disease (STD) Surveillance . . .402
(AACP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405
(NAMCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . .380
Masterfile . . . . . . . . . . . . . . . . . . . . . . . . . . .406
(NHANES) . . . . . . . . . . . . . . . . . . . . . . . . . . .382
(AAMC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406
(ASCO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407
Survey (MEPS).
(NNDSS) . . . . . . . . . . . . . . . . . . . . . . . . . . . .390
Acquired immunodeficiency syndrome (AIDS). . . . .409
(NSLTCP) . . . . . . . . . . . . . . . . . . . . . . . . . . . .391
Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . .409
(NSDUH) . . . . . . . . . . . . . . . . . . . . . . . . . . . .393
AIDSSee Appendix II, Acquired immunodeficiency
National Vital Statistics System (NVSS) . . . . . . . . . .395
syndrome (AIDS).
Birth File . . . . . . . . . . . . . . . . . . . . . . . . . . .395
Alcohol consumption . . . . . . . . . . . . . . . . . . . .412
Fetal Death Data Set . . . . . . . . . . . . . . . . . . . .396
Any-listed diagnosisSee Appendix II, Diagnosis.
Mortality Multiple Cause-of-Death File . . . . . . . .397
Average annual rate of change (percent
Linked Birth/Infant Death Data Set. . . . . . . . . . .398
change). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Occupational Employment Statistics (OES) . . . . . . .399
Average length of stay . . . . . . . . . . . . . . . . . . . .412
rates.
Health care contact . . . . . . . . . . . . . . . . . . . . . .427
Birthweight . . . . . . . . . . . . . . . . . . . . . . . . . . .413
Health expenditures, national . . . . . . . . . . . . . . .427
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . .415
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . .431
Contraception . . . . . . . . . . . . . . . . . . . . . . . . .421
HypertensionSee Appendix II, Blood pressure, high.
related rates.
Incidence . . . . . . . . . . . . . . . . . . . . . . . . . . . .437
related rates.
Health maintenance organization (HMO).
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .422
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .437
Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . .423
Injury-related visit . . . . . . . . . . . . . . . . . . . . . . .438
Discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . .423
Inpatient daySee Appendix II, Days of care.
Drug . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .423
coverage.
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . .424
home.
visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .424
Clinical Modification (ICD9CM) . . . . . . . . . . . . .439
time.
Late fetal death rateSee Appendix II, Rate: Death
national.
Leading causes of deathSee Appendix II, Cause-of-
related rates.
Long-term care facility . . . . . . . . . . . . . . . . . . . .440
Gestation . . . . . . . . . . . . . . . . . . . . . . . . . . . .427
Managed care . . . . . . . . . . . . . . . . . . . . . . . . .442
Medicaid. . . . . . . . . . . . . . . . . . . . . . . . . . . . .443
RegionSee Appendix II, Geographic region.
specialty.
Relative standard error (RSE) . . . . . . . . . . . . . . . .458
Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . . .445
Relative survival rate . . . . . . . . . . . . . . . . . . . . .459
(BMI).
Usual source of care. . . . . . . . . . . . . . . . . . . . . .461
Outpatient visit.
costs for employee compensation.
Physician. . . . . . . . . . . . . . . . . . . . . . . . . . . . .450
for age-adjusting death rates prior to 2001. . . . . . . . . .411
Population . . . . . . . . . . . . . . . . . . . . . . . . . . .451
Poverty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .451
Table IV. Cause-of-death codes, by applicable
Prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . .451
Diseases (ICD). . . . . . . . . . . . . . . . . . . . . . . . . . . . .416
specialty.
between the 9th and 10th revisions of the International
expenditures, national.
Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . .452
expenditures, national.
Modification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Health, United States consolidates the most current data categories. For example, cigarette use is measured by the
on the health of the population of the United States, the National Health Interview Survey, the National Survey on
availability and use of health care resources, and health care Drug Use & Health, the Monitoring the Future Study, and
expenditures. Information was obtained from the data files the Youth Risk Behavior Survey. These surveys use slightly
and published reports of many federal government, private, different questions, cover persons of differing ages, and
and global agencies and organizations. In each case, the interview in diverse settings (e.g., at school compared with
sponsoring agency or organization collected data using its at home), so estimates may differ.
own methods and procedures. Therefore, data in this report
may vary considerably with respect to source, method of Overall estimates generally have relatively small sampling
collection, definitions, and reference period. errors, but estimates for certain population subgroups may
be based on a small sample size and have relatively large
Although a detailed description and comprehensive sampling errors. Numbers of births and deaths from the
evaluation of each data source are beyond the scope of this National Vital Statistics System represent complete counts
appendix, readers should be aware of the general strengths (except for births in those states where data are based on a
and weaknesses of the different data collection systems 50% sample for certain years). Therefore, these data are not
shown in Health, United States. For example, population- subject to sampling error. However, when the figures are
based surveys are able to collect socioeconomic data and used for analytical purposes, such as the comparison of rates
information on the impact of an illness, such as limitation of over a period, the number of events that actually occurred
activity. These data are limited by the amount of information may be considered as one of a large series of possible results
a respondent remembers or is willing to report. For example, that could have arisen under the same circumstances. When
a respondent may not know detailed medical information, the number of events is small and the probability of such an
such as a precise diagnosis or the type of medical procedure event is rare, estimates may be unstable, and considerable
performed, and therefore cannot report that information. caution must be used in interpreting the statistics. Estimates
In contrast, records-based surveys, which collect data that are unreliable because of large sampling errors or small
from physician and hospital records, usually contain good numbers of events are noted with asterisks in tables, and the
diagnostic information but little or no information about the criteria used to determine unreliable estimates are indicated
socioeconomic characteristics of individuals or the impact of in an accompanying footnote.
illnesses on individuals.
In this appendix, government data sources are listed
Different data collection systems may cover different alphabetically by data set name, and private and global
populations, and understanding these differences is critical sources are listed separately. To the extent possible,
to interpreting the resulting data. Data on vital statistics government data systems are described using a standard
and national expenditures cover the entire population. format. The Overview is a brief, general statement about
However, most data on morbidity cover only the civilian the purpose or objectives of the data system. The Coverage
noninstitutionalized population and thus may not include section describes the population or events that the data
data for military personnel, who are usually young; for system covers: for example, residents of the United States,
institutionalized people, including the prison population, the noninstitutionalized population, persons in specific
who may be of any age; or for nursing home residents, who population groups, or other entities that are included in the
are usually older. survey or data system. The Methodology section presents a
short description of the methods used to collect the data.
All data collection systems are subject to error, and records The Sample Size and Response Rate section provides these
may be incomplete or contain inaccurate information. statistics for surveys. The Issues Affecting Interpretation
Respondents may not remember essential information, section describes major changes in the data collection
a question may not mean the same thing to different methodology or other factors that must be considered
respondents, and some institutions or individuals may when analyzing trends shown in Health, United States: for
not respond at all. It is not always possible to measure the example, a major survey redesign that may introduce a
magnitude of these errors or their effect on the data. Where discontinuity in the trend. For additional information about
possible, table notes describe the universe and method of the methodology, data files, and history of a data source,
data collection, to assist users in evaluating data quality. consult the References and For More Information sections that
follow each summary.
Some information is collected in more than one survey, and
estimates of the same statistic may vary among surveys
because of different survey methodologies, sampling
frames, questionnaires, definitions, and tabulation
Abortion Surveillance System Jatlaoui TC, Ewing A, Mandel MG, Simmons KB,
Suchdev DB, Jamieson DJ, Pazol K. Abortion
CDC/National Center for Chronic Disease Prevention surveillanceUnited States, 2013. MMWR Surveill
and Health Promotion (NCCDPHP) Summ 2016;65(SS12):144. Available from: http://
www.cdc.gov/mmwr/volumes/65/ss/ss6512a1.htm.
Overview. The Abortion Surveillance System documents
the number and characteristics of women obtaining legal For More Information. See the NCCDPHP surveillance
induced abortions in the United States. and research website at: http://www.cdc.gov/
reproductivehealth/Data_Stats/index.htm.
Coverage. The system includes women of all ages, including
adolescents, who obtain legal induced abortions.
American Community Survey (ACS)
Methodology. Each year, CDC requests tabulated data from U.S. Census Bureau
the central health agencies of 52 reporting areas (the 50
states, the District of Columbia [D.C.], and New York City)
Overview. ACS provides annual estimates of income,
to document the number and characteristics of women
education, employment, health insurance coverage, and
obtaining abortions in the United States. For the purpose
housing costs and conditions for U.S. residents. Estimates
of surveillance, a legal induced abortion is defined as
from ACS complement population data collected by
an intervention performed by a licensed clinician (e.g., a
the U.S. Census Bureau during the decennial census.
physician, nurse-midwife, nurse practitioner, or physician
Topics currently included on an annual basis in ACS were
assistant) that is intended to terminate a suspected or
previously collected once a decade through the decennial
known ongoing intrauterine pregnancy and produce a
census long form.
nonviable fetus.
Coverage. ACS covers U.S. residents residing in all 3,141
In most states, collection of abortion data is facilitated by
counties in the 50 states and D.C., and all 78 municipalities
the legal requirement for hospitals, facilities, and physicians
in Puerto Rico. ACS began data collection for U.S. residents
to report abortions to a central health agency. These central
residing in housing units in January 2005 and for residents
health agencies voluntarily report abortion data to CDC and
residing in group quarters facilities in January 2006. Annual
provide only the aggregate numbers for the abortion data
ACS estimates are available every year for states and for
they have collected through their independent surveillance
specific geographic areas with populations of 65,000 or more.
systems. Although reporting to CDC is voluntary, most
reporting areas provide aggregate abortion numbers;
Methodology. Starting with 2013 data, the ACS data
during 20032012, a total of 47 reporting areas provided
collection operation uses up to four modes to collect
CDC a continuous annual record of abortion numbers.
information: Internet, mail, telephone, and personal visit
interviews. The first mode includes a mailed request to
Issues Affecting Interpretation. Because reporting areas
respond to the ACS questionnaire over the Internet, followed
establish their own reporting requirements for abortion
later by an option to complete a paper questionnaire and
and send their data to CDC voluntarily, CDC is unable
return it by mail. If neither an Internet nor mail questionnaire
to obtain the total number of abortions performed in
is received, a follow-up interview by phone or personal visit
the United States. Although most states legally require
is attempted for a sample of nonrespondents. Prior to 2013,
medical providers to submit a report for all the abortions
Internet collection was not used, and only three modes of
they perform, enforcement of this requirement varies.
collection were used. Each month, a sample of housing unit
Additionally, although most reporting areas collect and
addresses and residents of group quarters facilities receive
send abortion data to CDC, during 20042013, 5 of the
questionnaires. Housing units include a house, apartment,
52 reporting areas did not provide CDC with data on a
mobile home or trailer, a group of rooms, or a single room
consistent annual basis (the five states that did not report
occupied as separate living quarters, or if vacant, intended
continuously for the period 20042013 were California,
for occupancy as separate living quarters. Group quarters
Louisiana, Maryland, New Hampshire, and West Virginia).
are places where people live or stay that are normally
Because of these limitations, during the period covered by
owned or managed by an entity or organization providing
this report the total annual number of abortions recorded
housing and services for the residents. These services may
by CDC was consistently approximately 70% of the number
include custodial or medical care as well as other types of
recorded by the Guttmacher Institute, which uses numerous
assistance, and residency is commonly restricted to persons
active follow-up techniques to increase the completeness
receiving these services. The group quarters population
of the data obtained through its periodic national census of
comprises both the institutional and noninstitutional group
abortion providers. (See Appendix I, Guttmacher Institute
quarters populations. The institutional group quarters
Abortion Provider Census.)
population includes residents under formally authorized
For the basic CPS, persons aged 15 and over in the civilian Beginning with 2001, the Childrens Health Insurance
noninstitutionalized population are eligible to participate; Program (CHIP) sample expansion was introduced. This
persons living in institutions such as prisons, long-term included an increase in the basic CPS sample to about
care hospitals, and nursing homes are not eligible for the 60,000 households per month in 2001. Prior to 2001,
survey. The CPS ASEC sample size is slightly larger than that estimates were based on about 50,000 households per
of the basic CPS because it includes members of the Armed month. The expansion also included an additional 12,000
Forces living in civilian housing units on a military base or households that were allocated differentially across
in households not on a military base. The CPS ASEC sample states based on prior information about the low-income,
also includes additional Hispanic households that are not uninsured children in each state. This expansion was made
included in the monthly CPS estimates. to improve the reliability of state estimates on the number
of children who lived in low-income families and lacked
Methodology. The basic CPS sample is selected from health insurance coverage.
multiple frames using multiple stages of selection. Each
unit is selected with a known probability to represent Issues Affecting Interpretation. Over the years, the number
similar units in the universe. The sample design is state- of income questions has expanded, questions on work
based, with the sample in each state being independent of experience and other characteristics have been added, and
the others. One person generally responds for all eligible the month of interview was moved to March. In 2002, an
members of a household. ASEC sample increase was implemented, requiring more
time for data collection. Thus, additional ASEC interviews are
The CPS interview is divided into three parts: (a) now taking place in February and April. However, even with
household and demographic information, (b) labor force this sample increase, most of the data collection still occurs
information, and (c) supplement information for months in March.
that include supplements.
In 1994, major changes were introduced that included a
Estimates of poverty presented in Health, United States from complete redesign of the questionnaire and the introduction
CPS are derived from ASEC. ASEC collects the usual monthly of computer-assisted interviewing for the entire survey. In
labor force data in addition to data on migration, longest addition, some of the labor force concepts and definitions
held job during the year, weeks worked, time spent looking were revised. Prior to this redesign, CPS data were primarily
for work or on layoff from a job, and income from all sources collected using a paper-and-pencil form. Beginning in
including noncash sources (e.g., food stamps, school lunch 1994, population controls were based on the 1990 census
program, employer-provided group health insurance plan, and adjusted for the estimated population undercount.
personal health insurance, Medicaid, Medicare, TRICARE or Starting with Health, United States, 2003, poverty estimates
military health care, and energy assistance). for data years 2000 and beyond were recalculated based
on the expanded CHIP sample, and Census 2000-based
The additional Hispanic sample in CPS ASEC is based on population controls were implemented. Starting with 2002
the previous Novembers basic CPS sample. If a person is data, race-specific estimates are tabulated according to the
identified as being of Hispanic origin from the November 1997 Revisions to the Standards for the Classification of Federal
interview and is still residing at the same address in March, Data on Race and Ethnicity and are not strictly comparable
that housing unit is eligible for the March survey. This with estimates for earlier years. Starting with Health, United
amounts to a near-doubling of the Hispanic sample because States, 2012, Census 2010-based population controls were
there is no overlap of housing units between the basic CPS implemented for poverty estimates for 2010 and beyond.
samples in November and March. For a discussion of the impact of the implementation of the
Census 2010-based controls on poverty estimate trends, see:
The ASEC sample weight is an adjusted version of the final DeNavas-Walt, Proctor, and Smith (2012).
CPS sample weight. The final CPS sample weight is the
product of the basic weight, the adjustments for special For 2013 data, the CPS ASEC used a split panel to test a
weighting, the noninterview adjustment, the first-stage ratio new set of income questions. Starting with Health, United
adjustment factor, and the second-stage ratio adjustment States, 2015, estimates for 2013 are presented two ways:
Department of Veterans Affairs National HCUPNIS contains a core set of clinical and nonclinical
Enrollment and Patient Databases information found in a typical discharge abstract,
including all-listed diagnoses and procedures, discharge
Department of Veterans Affairs (VA) status, patient demographics, and charges for all patients
regardless of payer (e.g., persons covered by Medicare,
Overview. The VA compiles and analyzes multiple data Medicaid, and private insurance, as well as those without
sets on the health and health care of its clients and other insurance coverage).
veterans. Monitoring access and quality of care enables
the VA to conduct program and policy evaluations. The Coverage. In 2014, HCUPNIS covered about 95% of all U.S.
VA maintains nationwide systems that contain a statistical community hospital discharges (excluding discharges from
record for each episode of care provided under VA auspices rehabilitation or long-term acute care hospitals) from 44
as well as in VA and non-VA hospitals, nursing homes, VA states and D.C. Community hospitals are defined by the
residential rehabilitation treatment programs (formerly American Hospital Association as nonfederal, short-term,
called domiciliaries), and VA outpatient clinics. The VA also general, and other specialty hospitals, excluding hospital
maintains enrollment information for each veteran enrolled units of institutions.
in the VA health care system.
The number of states participating in HCUPNIS has
Coverage. U.S. veterans who receive services within the VA generally increased each year. In the years of data presented
medical system are included. Data are available for some in Health, United States, the number of states participating
nonveterans who receive care at VA facilities. was 28 in 2000, 37 in 2005, 45 in 2010, 46 in 2011, 44 in 2012,
43 states and D.C. in 2013, and 44 states and D.C. in 2014.
Methodology. Encounter data from VA clinical information In 2014, all states except Alabama, Alaska, Delaware, Idaho,
systems are collected locally at each VA medical center and Mississippi, and New Hampshire were included.
transmitted electronically to the VAs Austin Automation
Center for use in providing nationwide statistics, reports, Methodology. In 2012, HCUPNIS was redesigned to
and comparisons. improve national estimates. To highlight the design change,
discharge records from all HCUP-participating hospitals. It Introduction to the HCUP National Inpatient Sample
approximates a 20% stratified sample of discharges from (NIS), 2014. In: Healthcare Cost and Utilization
long-term acute care hospitals. The information abstracted in health data. Rockville, MD: AHRQ; 2016. Available
Prior to 2012, HCUPNIS was designed to approximate a Inpatient Sample (NIS) redesign final report; 2014.
20% stratified sample of U.S. community hospitals, rather HCUP Methods Series Report # 201404 ONLINE.
than a sample of discharges. The pre-2012 HCUPNIS was April 4, 2014. U.S. Agency for Healthcare Research and
a stratified probability sample of hospitals in the frame, Quality. Available from: https://www.hcup-us.ahrq.gov/
Medical Expenditure Panel Survey (MEPS) Issues Affecting Interpretation. The 1987 estimates are based
on NMES, and 1996 and later years estimates are based
Agency for Healthcare Research and Quality (AHRQ) on MEPS. Because expenditures in NMES were based
primarily on charges, whereas those for MEPS were based
Overview. MEPS produces nationally representative
on payments, data for NMES were adjusted to be more
estimates of health care use, expenditures, sources of
comparable with MEPS by using estimated charge-to
payment, insurance coverage, and quality of care. MEPS
payment ratios for 1987. For a detailed explanation of this
consists of three components: the Household Component
adjustment, see Zuvekas and Cohen (2002).
(HC), the Medical Provider Component (MPC), and the
Insurance Component (IC). Data from MEPSHC and MEPS
References
MPC are used in Health, United States.
Ezzati-Rice TM, Rohde F, Greenblatt J. Sample design
Coverage. The U.S. civilian noninstitutionalized population is
of the Medical Expenditure Panel Survey Household
the primary population represented.
Component, 19982007. Methodology report no 22.
Rockville, MD: Agency for Healthcare Research and
Methodology. MEPSHC is a national probability survey
Quality; 2008. Available from: https://meps.ahrq.gov/
conducted annually since 1996. The panel design of the
mepsweb/data_files/publications/mr22/mr22.shtml.
survey features five rounds of interviewing covering two full
calendar years. The HC is a nationally representative survey
Zuvekas SH, Cohen JW. A guide to comparing health
of the civilian noninstitutionalized population drawn from
care expenditures in the 1996 MEPS to the 1987 NMES.
a subsample of households that participated in the prior
Inquiry 2002;39(1):7686.
years National Health Interview Survey. Missing expenditure
data in the HC are imputed largely from data collected in the
For More Information. See the MEPS website at: https://meps.
MPC.
ahrq.gov/mepsweb/.
The MPC collects data from hospitals, physicians, home
health care providers, and pharmacies that were reported Medicare Administrative Data
in the HC as providing care to MEPS sample persons. Data
are collected in the MPC to improve the accuracy of the Centers for Medicare & Medicaid Services (CMS)
expenditure estimates that would be obtained if derived
solely from the HC. The MPC is particularly useful in Overview. CMS collects and synthesizes Medicare enrollment,
obtaining expenditure information for persons enrolled in spending, and claims data to monitor and evaluate access to
managed care plans and Medicaid recipients. Sample sizes and quality of care, trends in utilization, changes in payment
for the MPC vary from year to year depending on the HC policy, and other program-related issues. Data include
sample size and the MPC sampling rates for providers. claims information for services furnished to Medicare fee-
for-service beneficiaries and Medicare enrollment data.
The MEPS predecessor, the 1987 National Medical Claims data include type of service, procedures, diagnoses,
Expenditure Survey (NMES), consisted of two components: dates of service, charge amounts, and payment amounts.
the Household Survey (HS) and the Medical Provider Survey Enrollment data include date of birth, sex, race, and reason
(MPS). The NMESHS component was designed to provide for entitlement.
Overview. MTF is an ongoing study that uses annual Miech RA, Johnston LD, O'Malley PM, Bachman JG,
surveys to track the behaviors, attitudes, and values of U.S. Schulenberg JE. Monitoring the Future National Survey
secondary school students, college students, and adults results on drug use: 19752015. Vol I, Secondary
through age 55. Data collected include lifetime, annual, and school students. Ann Arbor, MI: Institute for Social
30-day prevalence of use of many illegal drugs, inhalants, Research, The University of Michigan; 2016. Available
tobacco, and alcohol. from: http://www.monitoringthefuture.org/pubs/
monographs/mtf-vol1_2015.pdf.
Coverage. MTF surveys a sample of 12th, 10th, and
8th graders in public and private high schools in the Cowan CD. Coverage, sample design, and weighting
coterminous United States. Follow-up questionnaires are in three federal surveys. J Drug Issues 2001;31(3):599
mailed to a sample of each graduating class for a number of 614.
years after their initial participation, to gather information
on college students, young adults, and older adults.
Private health insurance spending for health care goods and For More Information. See the CMS National Health
services is derived using data from the U.S. Census Bureau, the Expenditure Accounts website at: http://www.cms.
American Medical Association (AMA), the American Hospital gov/Research-Statistics-Data-and-Systems/Statistics
Association (AHA), and IMS Health, as well as household data Trends-and-Reports/NationalHealthExpendData/
from surveys such as the National Medical Care Expenditure NationalHealthAccountsHistorical.html.
Survey (National Center for Health Services Research, 1987)
and later, MEPS (AHRQ, 19962015). The net cost of private
health insurance (which includes administrative costs, National Health Interview Survey (NHIS)
additions to reserves, rate credits and dividends, premium
taxes, and net underwriting gains or losses) is estimated
NCHS
using data from A.M. Best (Oldwick, NJ), the National
Overview. NHIS monitors the health of the U.S. population
Association of Insurance Commissioners, BLS surveys on the
through the collection and analysis of data on a broad range
cost of employer-sponsored health insurance and consumer
of health topics. A major strength of this survey lies in the
expenditures, MEPS data for self-insured plans, data from
ability to analyze health measures by many demographic
privately funded surveys, and numerous consulting firms and
and socioeconomic characteristics. During household
private health insurance trade organizations.
interviews, NHIS obtains information on activity limitation,
illnesses, injuries, chronic conditions, health insurance
Estimates of federal health care program spending (e.g.,
coverage (or lack thereof ), utilization of health care, and
Medicare, Medicaid, and Department of Defense) were
other health topics.
developed using administrative records maintained by the
servicing agencies. Out-of-pocket spending (direct spending
Coverage. The survey covers the civilian noninstitutionalized
by consumers for copayments, coinsurance, deductibles,
population of the United States. Among those excluded
and payments for goods and services not covered by
are patients in long-term care facilities, persons on active
insurance) was estimated using data from SAS (U.S. Census
duty with the Armed Forces (although their dependents are
Overview. Human immunodeficiency virus (HIV) surveillance CDC. HIV surveillance report. Atlanta, GA; [published
data are used to detect and monitor cases of HIV infection annually]. Available from: http://www.cdc.gov/hiv/
in the United States, evaluate epidemiologic trends, identify library/reports/hiv-surveillance.html.
unusual cases requiring follow-up, and inform public health
efforts to prevent and control the disease. Data collected on For More Information. See the NCHHSTP website at:
persons diagnosed with HIV infection include age, sex, race, http://www.cdc.gov/nchhstp.
ethnicity, mode of exposure, and geographic region.
Coverage. All 50 states, D.C., and six U.S. dependent areas National Hospital Ambulatory Medical
(American Samoa, Guam, Northern Mariana Islands, Puerto
Rico, Republic of Palau, and the U.S. Virgin Islands) report
Care Survey (NHAMCS)
confirmed diagnoses of HIV infection to CDC using a uniform NCHS
surveillance case definition and case report form. As of April
2008, all reporting areas had implemented confidential, Overview. NHAMCS provides national data on the provision
name-based HIV infection reporting and agreed to participate and use of medical care services in hospital emergency and
in CDCs National HIV Surveillance System. Health, United outpatient departments, using information collected from
States only presents data for the 50 states and D.C. medical records. Data are collected on types of providers
seen; reason for visit; diagnoses; drugs ordered, provided,
Methodology. HIV surveillance includes case report data from or continued; and selected procedures and tests performed
50 states, D.C., and six dependent areas. Using a standard during the visit. Patient data include age, sex, race, and
confidential case report form, the health departments collect expected source of payment. Data are also collected on
information that is then transmitted electronically, without selected characteristics of the hospitals included in the survey.
personal identifiers, to CDC.
Coverage. NHAMCS covers visits to emergency departments
The 2015 HIV Surveillance Report marks the transition to (EDs) and outpatient departments (OPDs) of nonfederal,
presenting diagnosis, death, and prevalence data without short-stay, or general hospitals in the United States.
statistical adjustments for delays in reporting of cases to CDC. Telephone contacts are excluded. Starting in 2009, the
survey includes visits to hospital-based ambulatory surgery
Because a substantial proportion of cases of HIV infection centers (ASCs). Starting in 2010, visits to freestanding ASCs
are reported to CDC without an identified risk factor, are included in the survey.
multiple imputation is used to assign a transmission
category. Multiple imputation is a statistical approach in
Bureau of Economic Analysis (BEA) NIPA measures are built up from a wide range of source
data using a variety of estimating methods. To ensure
Overview. NIPA are a set of economic accounts that provide consistency and accuracy, NIPA use various adjustment
detailed measures of the value and composition of national and estimation techniques to estimate data. Three general
output and the incomes generated in the production of types of adjustments are made to the source data that are
that output. Essentially, NIPA provide a detailed snapshot incorporated into the NIPA estimates. The first consists of
of the myriad transactions that make up the economy adjustments that are needed so that the data conform to
buying and selling goods and services, hiring of labor, appropriate NIPA concepts and definitions. The second type
investing, renting property, paying taxes, and the like. NIPA of adjustment involves filling gaps in coverage. The third
estimates show U.S. production, distribution, consumption, type of adjustment involves time of recording and valuation.
investment, and saving. Source data must occasionally be adjusted to account
for special circumstances that affect the accuracy of the
The best-known NIPA measure is the gross domestic product data. For example, quarterly and monthly NIPA estimates
(GDP), which is defined as the market value of the goods are seasonally adjusted at the detailed-series level when
and services produced by labor and property located in the series demonstrate statistically significant seasonal
the United States. NIPA calculate GDP as the sum of familiar patterns. Source data may also be used as indicators to
final expenditure components: personal consumption extrapolate annual estimates. For more information, see An
expenditures, private investment, government spending introduction to the National Income and Product Accounts
(consumption and investment), and net exports. However, methodology papers: U.S. National Income and Product
GDP is just one of many economic measures presented in Accounts, available from: http://www.bea.gov/scb/pdf/
NIPA. Another key NIPA indicator presented in Health, United national/nipa/methpap/mpi1_0907.pdf; and Concepts
States is the implicit price deflator for GDP. and methods of the U.S. National Income and Product
Accounts, available from: http://www.bea.gov/national/pdf/
The conceptual framework of NIPA is illustrated by seven NIPAhandbookch1-4.pdf.
summary accounts: the domestic income and product
account, the private enterprise income account, the personal
For More Information. See the BEA (NIPA) website at: http:// State epidemiologists report cases of nationally notifiable
www.bea.gov/national/index.htm. diseases to CDC, which tabulates and publishes these data
in Morbidity and Mortality Weekly Report (MMWR) and in
Summary of Notifiable Diseases, United States (before 1985,
National Medical Expenditure Survey titled Annual Summary).
(NMES)See Appendix I, Medical
Issues Affecting Interpretation. NNDSS data must be
Expenditure Panel Survey (MEPS). interpreted in light of reporting practices. Some diseases
that cause severe clinical illness (for example, plague and
rabies) are likely reported accurately if diagnosed by a
National Notifiable Diseases Surveillance clinician. However, persons who have diseases that are
System (NNDSS) clinically mild and infrequently associated with serious
consequences (e.g., salmonellosis) may not seek medical
CDC care from a health care provider. Even if these less severe
diseases are diagnosed, they are less likely to be reported.
Overview. The CDC National Notifiable Diseases Surveillance
System (NNDSS) is a nationwide collaboration that
The degree of completeness of data reporting is also
enables all levels of public health (local, state, territorial,
influenced by the diagnostic facilities available, the control
federal, and international) to share health information to
measures in effect, public awareness of a specific disease,
monitor, control, and prevent the occurrence and spread
and the interests, resources, and priorities of state and
of state-reportable and nationally notifiable infectious
local officials responsible for disease control and public
and some noninfectious diseases and conditions. NNDSS
health surveillance. Finally, factors such as changes in case
is a multifaceted program that includes the surveillance
definitions for public health surveillance, introduction
system for collection, analysis, and sharing of health data,
of new diagnostic tests, or discovery of new disease
resources, and information about policies and standards,
entities can cause changes in disease reporting that are
at the local, state, and national levels. NNDSS provides
independent of the true incidence of disease.
weekly provisional and annual finalized information on the
occurrence of diseases defined as notifiable by the Council
Reference
of State and Territorial Epidemiologists (CSTE). Data include
incidence of reportable diseases, which are nationally
CDC. Summary of notifiable diseasesUnited States,
notifiable using uniform surveillance case definitions.
2014. MMWR 2016;63(54):1152. Available from: http://
www.cdc.gov/mmwr/mmwr_nd/index.html.
Coverage. Notifiable disease reports are received from health
departments in the 50 states, five territories, D.C., and New
For More Information. See the NNDSS website at: http://
York City. Policies for reporting notifiable disease cases can
wwwn.cdc.gov/nndss/.
vary by disease or reporting jurisdiction, depending on case
status classification (i.e., confirmed, probable, or suspect).
and discharges include demographic characteristics, health B, Foley DJ. The National Nursing Home Survey: 1977
status, services received, and sources of payment. summary for the United States. Vital Health Stat 13(43).
personal or domiciliary care. The 1977 NNHS encompassed Home Survey: 1985 summary for the United States.
all types of nursing homes, including personal care and Vital Health Stat 13(97). Hyattsville, MD: NCHS; 1989.
domiciliary care homes. The 1985, 1995, 1997, 1999, and Available from: http://www.cdc.gov/nchs/data/series/
Methodology. The survey used a stratified two-stage health statistics; no 280. Hyattsville, MD: NCHS; 1997.
probability design. The first stage was the selection of Available from: http://www.cdc.gov/nchs/data/ad/
facilities, and the second stage was the selection of residents ad280.pdf.
facility. The 2004 survey was designed to select only current National Nursing Home Survey: 2004 overview. Vital
residents, 12 from each facility, to participate in the survey. Health Stat 13(167). Hyattsville, MD: NCHS; 2009.
Information on the facility was collected through a personal Available from: http://www.cdc.gov/nchs/data/series/
NSDUH uses a 50-state (and D.C.) sample design that The NSDUH questionnaire underwent a partial redesign in
is revised periodically. In 2014, NSDUH introduced an 2015 to improve the quality of NSDUH data and to address
independent multistage area probability sample within each the changing needs of policymakers and researchers with
state and D.C. States are the first level of stratification. Each regard to substance use and mental health issues. Due to the
state was stratified into approximately equally populated changes, only 2015 data are presented for certain estimates
state sampling regions (SSRs), and then census tracts within until comparability with prior years can be established.
each SSR were selected, census block groups within census Trends continue to be presented for estimates that are
tracts, and area segments (i.e., a collection of census blocks) assumed to have remained comparable with those in earlier
within census block groups. Finally, dwelling units (DUs) years. For more information, see: https://www.samhsa.gov/
were selected within segments, and within each selected data/sites/default/files/NSDUH-TrendBreak-2015.pdf.
DU, up to two residents who were at least 12 years old were
selected for the interview. Estimates of substance use for youth based on NSDUH
are not directly comparable with estimates based on the
In addition, in 2014, changes were made in the sample Monitoring the Future (MTF) Study and the Youth Risk
sizes allocated to each state and to different age groups, in Behavior Survey (YRBS). In addition to the fact that MTF
order to increase the precision of national and many state excludes dropouts and absentees, rates are not directly
estimates as well as estimates for older adults. In particular, comparable across these surveys because of differences in
samples sizes were increased in the 12 most populous the populations covered, sample design, questionnaires,
states. States with sample increases will have more precise and interview setting. NSDUH collects data in residences,
estimates than in previous years, whereas states with whereas MTF and YRBS collect data in school classrooms.
smaller sample sizes will have some reductions in precision. Further, NSDUH estimates are tabulated by age, whereas
However, all states will still have reasonable levels of
MTF and YRBS estimates are tabulated by grade,
precision. This allocation of sample to states is also thought
representing different ages as well as different populations.
to be more cost-efficient. Starting in 2014, the sample size
was redistributed by age group so that 25% of the sample
References
is allocated to those aged 1217, 25% to those aged 1825,
and 50% to those aged 26 or older. Although the sample
Substance Abuse and Mental Health Services
sizes for age groups 1217 and 1825 were reduced, these
two groups are still considered to be oversampled since Administration. 2014 National Survey on Drug Use
they represent approximately 10% and 13% of the total and Health: Methodological summary and definitions.
population, respectively. Rockville, MD: SAMHSA; 2015. Available from:
http://www.samhsa.gov/data/sites/default/
Sample Size and Response Rate. Nationally, 132,210 files/NSDUH-MethodSummDefs2014/NSDUH
household addresses were successfully screened for the MethodSummDefs2014.pdf.
2015 survey, conducted from January to December 2015.
In 2015, screening was completed at 132,210 addresses, Substance Abuse and Mental Health Services
and 68,073 completed interviews were obtained, including Administration. Results from the 2014 National Survey
16,955 interviews from adolescents aged 1217 and 51,118 on Drug Use and Health: Detailed tables. Rockville, MD:
interviews from adults aged 18 or over. Weighted response SAMHSA; 2015. Available from: http://www.samhsa.
rates were 79.7% for household screening and 69.3% for gov/data/sites/default/files/NSDUH-DetTabs2014/
interviewing. NSDUH-DetTabs2014.htm.
Issues Affecting Interpretation. Several improvements to Substance Abuse and Mental Health Services
the NSDUH were implemented in 2002. The data collected Administration. Key substance use and mental
in 2002 represent a new baseline for tracking trends in health indicators in the United States: Results from
substance use and other measures. Special questions on the 2015 National Survey on Drug Use and Health.
methamphetamine were added in 2005 and 2006. Data for Rockville, MD: SAMHSA; 2016. Available from: https://
years prior to 2007 were adjusted for comparability. Starting www.samhsa.gov/data/sites/default/files/NSDUH
with 2011 data, 2010-census based control totals were FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf.
used in the weighting process. Analysis weights in the 2002
through 2010 NSDUHs were derived from the 2000 census Substance Abuse and Mental Health Services
data. This reweighting to the 2010 census data could affect Administration. Results from the 2015 National Survey
Coverage. Data presented in Health, United States are based There is substantial evidence that not all fetal deaths
on reporting from all 50 states and D.C. Data for Puerto for which reporting is required are, in fact, reported.
Rico, Virgin Islands, Guam, American Samoa, and Northern Underreporting of fetal deaths is most likely to occur in the
Marianas are not included in U.S. totals but are included in earlier part of the required reporting period for each state.
the Fetal Death User Guide available from the NCHS website For example, in 2013, for those states requiring reporting of
at: http://www.cdc.gov/nchs/data_access/VitalStatsOnline. fetal deaths at all periods of gestation, 56.4% of fetal deaths
htm, and in periodic reports. at 20 weeks of gestation or more were at 2027 weeks,
whereas for states requiring reporting of fetal deaths of
Methodology. Fetal death means the death of a fetus prior 500 grams or more, only 33.8% were at 2027 weeks, thus
to delivery from the mother, irrespective of the duration indicating substantial underreporting of early fetal deaths in
of pregnancy. Fetal deaths do not include induced some states.
The Mortality multiple cause-of-death file includes In addition, NCHS has developed two computer
demographic information on age, sex, race, Hispanic origin, systems as inputs to ACME. Beginning with 1990 data,
state of residence, and educational attainment, as well as the Mortality Medical Indexing, Classification, and
medical information on causes of death. This data set is one Retrieval system (MICAR) was introduced to automate
of the few sources of comparable health-related data for coding of multiple causes of death. MICAR provides
small geographic areas over an extended time period. The more detailed information on the conditions reported
data are used to present the characteristics of those dying on death certificates than is available through the ICD
in the United States, to determine life expectancy, and to code structure. Then, beginning with data year 1993,
compare mortality trends with those in other countries. SuperMICAR, an enhancement of MICAR, was introduced.
SuperMICAR allows for literal entry of the multiple cause-
Coverage. Mortality data presented in Health, United States of-death text as reported by the certifier. This information
are based on reporting from all 50 states and D.C. Data is then processed automatically by the MICAR and ACME
for Puerto Rico, Virgin Islands, Guam, American Samoa, computer systems. Records that cannot be processed
and Northern Marianas are shown in selected state automatically by MICAR or SuperMICAR are multiple-
tables, but are not included in U.S. totals. Beginning with cause-coded manually and then further processed
1970, mortality statistics for the U.S. exclude deaths of through ACME. Starting in 2003, SuperMICAR was used to
nonresidents of the U.S. Mortality statistics for Puerto Rico, process all of the nations death records.
In Health, United States, vital rates for 19911999 were All certified facilities are inspected periodically by
calculated using the July 1, 1991July 1, 1999 bridged-race representatives of the state survey agency (generally the
intercensal estimates. Vital rates for 2000 were calculated department of health). Some facilities are inspected twice,
using the bridged-race April 1, 2000, census counts, and or more often, during any given reporting cycle. To avoid
those for 2010 were calculated using the bridged-race April overcounting, the data must be edited and duplicates
1, 2010, census counts. Starting with Health, United States, removed. Data editing and compilation of nursing home
2012, vital rates for 20012009 have been recalculated using data were performed by Cowles Research Group (CRG;
Anacortes, WA) and published in the groups Nursing Home
the July 1, 2001July 1, 2009, revised intercensal bridged-
Statistical Yearbook series.
race population estimates. Vital rates for 2011 and beyond
will be calculated using bridged-race estimates of the July 1
References
population from the corresponding postcensal vintage.
Cowles CM, ed. Nursing home statistical yearbooks
Reference
for 20032015. Anacortes, WA: CRG; published
20042016, respectively. Available from: http://www.
Ingram DD, Parker JD, Schenker N, et al. United States
longtermcareinfo.com/publications/nursing-home
Census 2000 population with bridged race categories.
statistical-yearbook.php.
NCHS. Vital Health Stat 2003;2(135). Available from:
http://www.cdc.gov/nchs/data/series/sr_02/sr02_135.
Centers for Medicare & Medicaid Services.
pdf.
Certification and compliance. Baltimore, MD:
CMS; 2005. Available from: http://www.cms.gov/
For More Information. See the U.S. Census Bureau website
CertificationandComplianc/01_overview.asp.
at: http://www.census.gov and the NCHS website for U.S.
Census populations with bridged race categories at: http://
For More Information. See the CMS website at: https://www.
www.cdc.gov/nchs/nvss/bridged_race.htm.
cms.gov/Research-Statistics-Data-and-Systems/Files-for
Order/NonIdentifiableDataFiles/index.html and the CRG
Quality Improvement Evaluation System website at: http://www.longtermcareinfo.com/index.html.
Sample Size and Response Rate. The sample size for the
Youth Risk Behavior Survey (YRBS) 2015 YRBS was 15,624 students in 180 schools. The school
response rate was 69%, and the student response rate was
CDC/National Center for HIV, Hepatitis, STD, and TB 86%, for an overall response rate of 60%.
Prevention (NCHHSTP)
Issues Affecting Interpretation. National YRBS data are subject
Overview. YRBS monitors health risk behaviors among to at least two limitations. First, these data apply only to
students in grades 912 that contribute to morbidity and adolescents who attend regular high school, including some
mortality in both adolescence and adulthood. The six areas charter, public alternative, special education, and vocational
schools. These students may not be representative of all
monitored are behaviors that contribute to unintentional
persons in this age group because those who have dropped
injuries and violence; tobacco use; alcohol and other
out of high school are not surveyed. Second, the extent of
drug use; sexual behaviors that contribute to unintended
underreporting or overreporting cannot be determined,
pregnancy and sexually transmitted diseases (STDs),
although the survey questions demonstrate good test-retest
including human immunodeficiency virus (HIV) infection; reliability.
unhealthy dietary behaviors; and physical inactivity. In
addition, YRBS monitors the prevalence of obesity, asthma, Estimates of substance use for youth based on YRBS differ
and sleep behaviors. from the National Survey on Drug Use & Health (NSDUH)
and the Monitoring the Future (MTF) Study. Rates are
Coverage. National data are representative of high school not directly comparable across these surveys because
students in public and private schools in the United States. of differences in populations covered, sample designs,
questionnaires, and interview settings. NSDUH collects data
Methodology. The national YRBS school-based surveys in residences, whereas MTF and YRBS collect data in school
have been conducted biennially since 1991. A three-stage classrooms. In addition, NSDUH estimates are tabulated
cluster sample design is used to produce a nationally by age, whereas MTF and YRBS estimates are tabulated
representative sample of students in grades 912 attending by grade, representing different ages as well as different
public and private schools. In 2013 and 2015, the first-stage populations. All YRBS data collection is anonymous.
sampling frame comprised primary sampling units (PSUs)
consisting of counties, subareas of large counties, or groups References
of smaller, adjacent counties. PSUs were categorized into
strata according to their metropolitan statistical area (MSA) Brener ND, Kann L, Shanklin SL, et al. Methodology of
status (e.g., urban city) and the percentages of non-Hispanic the Youth Risk Behavior Surveillance System2013.
black and Hispanic students in the PSUs. PSUs were sampled MMWR 2013;62(RR01):123. Available from: http://
with probability proportional to overall school enrollment www.cdc.gov/mmwr/preview/mmwrhtml/rr6201a1.
size for the PSU. In the second stage of sampling, schools htm.
with any of grades 912 were sampled with probability
proportional to school enrollment size. The third stage of Kann L, Kinchen S, Shanklin SL, et al. Youth Risk
sampling consisted of random sampling in each of grades Behavior SurveillanceUnited States, 2013. MMWR
912, one or two classrooms from either a required subject Surveill Summ 2014;63(SS4):1172. Available from:
(e.g., English or Social Studies) or a required period (e.g., http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf.
Homeroom or second period).
Kann L, McManus T, Harris WA, et al. Youth Risk
All students in sampled classes were eligible to participate. Behavior SurveillanceUnited States, 2015. MMWR
Schools, classes, and students that refused to participate Surveill Summ 2016;65(SS6):1174. Available from:
were not replaced. To enable a separate analysis of data for https://www.cdc.gov/healthyyouth/data/yrbs/
black and Hispanic students, two classes per grade, rather pdf/2015/ss6506_updated.pdf.
than one, were sampled in schools with a high enrollment of
black and Hispanic students. Prior to 2013, three strategies
For More Information. See the YRBS website at: http://www. AACPM compiles data on colleges of podiatric medicine,
cdc.gov/yrbs. including information on the schools and enrollment. Data
are collected annually through written questionnaires. The
response rate is 100%.
Private and Global Sources
Reference
American Association of Colleges of
American Association of Colleges of Podiatric
Osteopathic Medicine (AACOM) Medicine. Applicant, matriculant, and graduate
statistics. Available from: http://www.aacpm.org.
AACOM compiles data on various aspects of osteopathic
medical education for distribution to the profession, the
government, and the public. Enrollment and graduate data For More Information. See the AACPM website at: http://
are collected by the Annual Osteopathic Medical School www.aacpm.org.
Questionnaire, which is sent to schools of osteopathic
medicine annually. The questionnaire requests information
on the characteristics of applicants, students and graduates, American Dental Association (ADA)
faculty, curriculum, contract and grant activity, revenues and
expenditures, and clinical facilities. The ADA Masterfile contains the most up-to-date
information on dentists in the United States. The Masterfile is
Reference a database of all dentists, both practicing and nonpracticing,
in the United States. It is updated through a variety of
American Association of Colleges of Osteopathic methods including reconciliation with state licensure
Medicine. Trends in osteopathic medical school databases, death records, and various surveys and censuses
applicants, enrollment, and graduates, 2016. Chevy of dentists carried out by ADA.
Chase, MD: AACOM; 2016.
ADAs Health Policy Institute conducts annual surveys of
For More Information. See the AACOM website at: http:// predoctoral dental educational institutions. A questionnaire,
www.aacom.org. mailed to all dental schools, collects information on
academic programs, admissions, enrollment, attrition,
graduates, educational expenses and financial assistance,
American Association of Colleges of patient care, advanced dental education, and faculty
Pharmacy (AACP) positions.
Association of Schools and Colleges of Optometry. The abortion data reported to Guttmacher contain data
Annual student data report: Academic year 20142015 on women of all ages, including adolescents who obtain
(updated August, 2016). Rockville, MD: ASCO; 2015. legal induced abortions, and includes both surgical and
Available from: http://www.opted.org/student-data medication (e.g., using mifepristone, misoprostol, or
reports/. methotrexate) abortion procedures. Data are collected from
three major categories of providers that were identified as
Association of Schools and Colleges of Optometry. potential providers of abortion services: clinics, physicians,
Annual student data report: Academic year 20152016. and hospitals.
Rockville, MD: ASCO; 2016. Available from: http://www.
opted.org/student-data-reports/. Questionnaires are mailed to all potential providers, with
two additional mailings and telephone follow-up for
For More Information. See the ASCO website at: http://www. nonresponse. All questionnaires ask the number of induced
opted.org. abortions performed at the providers location. State
health statistics agencies are also contacted, requesting all
available data reported by providers to each state health
Association of Schools & Programs of agency on the number of abortions performed in the survey
Public Health (ASPPH) year. For states that provide data to Guttmacher, the health
agency figures are used for providers who do not respond to
ASPPH compiles data on member schools and programs of the survey. Estimates of the number of abortions performed
public health accredited by the Council on Education for by some providers are ascertained from knowledgeable
Public Health in the United States, Puerto Rico, Mexico, and sources, including other providers of reproductive health
Canada. Unlike health professional schools that emphasize services.
specific clinical occupations, schools and programs of public
health offer study in specialty areas such as biostatistics, In the 20122013 survey, respondents were asked to
epidemiology, environmental health, occupational health, report the number of induced abortions performed in
health administration, health planning, nutrition, maternal their facilities during 2010 and 2011. Of the 2,288 potential
and child health, social and behavioral sciences, and other providers surveyed between April 2012 and May 2013,
population-based sciences. Data collection is conducted 1,222 responded directly or in follow-up; health department
annually from all ASPPH member schools and programs data were used for 470 providers; 71 facilities had closed or
and is reported in this report for U.S.-based institutions. The stopped offering abortion services during the survey period;
response rate in 20142015 was 85%. knowledgeable sources were used for 51 providers; and
Guttmacher made its own estimates for 474 facilities, usually
Reference relying on prior abortion census results. The level of internal
estimation was higher than in the 2008 survey.
Association of Schools and Programs of Public Health
[unpublished data]. Washington, D.C.: ASPPH; 2015. Between 2003 and 2011, the total number of abortions
reported to CDC has been about one-third less than the
For More Information. See the ASPPH website at: http://www. total estimated by Guttmacher. (See Appendix I, Abortion
aspph.org. Surveillance System.)
Reference
This appendix contains an alphabetical listing of terms used Activities of daily living (ADL)ADLs are activities related
in Health, United States, and these definitions are specific to personal care and include bathing or showering, dressing,
to the data presented in this report. The methods used getting into or out of bed or a chair, using the toilet, and
for calculating age-adjusted rates, average annual rates of eating. In the National Health Interview Survey, respondents
change, relative standard errors, birth rates, death rates, were asked whether they or family members need the help
and years of potential life lost are described. Included are of another person with personal care activities, such as
standard populations used for age adjustment (Tables eating, bathing, dressing, or getting around inside the home
I and II), the years when the revisions for International because of a physical, mental, or emotional problem.
Classification of Diseases (ICD) codes were in effect (Table
III), codes for cause of death from the 6th through 10th In the Medicare Current Beneficiary Survey, the following
revisions of ICD (Table IV), and comparability ratios between personal care activities are defined as ADLs: bathing or
the 9th and 10th revisions (ICD9 and ICD10) for selected showering, dressing, getting into or out of bed or a chair,
causes (Table V), imputed family income percentages from using the toilet, and eating. If a sample person had any
the National Health Interview Survey (NHIS) (Table VI), an difficulty performing an activity by him- or herself and
analysis of the effect of added probe questions for Medicare without special equipment, or did not perform the activity at
and Medicaid coverage on health insurance rates in NHIS all because of health problems, the person was categorized
(Table VII), industry codes from the North American Industry as having a limitation in that activity. The limitation may
Classification System (NAICS) (Table VIII), and ICD9 Clinical have been temporary or chronic at the time of interview.
Modification (ICD9CM) codes for external causes of injury Sampled persons who were administered a community
and procedure categories (Tables IX and X). Standards for interview answered questions about health status and
presenting federal data on race and ethnicity are described, functioning themselves, if able to do so. If the sample person
and sample tabulations of NHIS data comparing the 1977 was not able to respond, a proxy answered the questions.
and 1997 Office of Management and Budget standards for For persons in a long-term care facility, a proxy, such as a
the classification of federal data on race and ethnicity are nurse, answered questions about the sample persons health
presented in Tables XI and XII. status and functioning. Starting in 1997, interview questions
for people residing in long-term care facilities were changed
Acquired immunodeficiency syndrome (AIDS)Human slightly from those administered to people living in the
immunodeficiency virus (HIV) is the pathogen that causes community in order to differentiate residents who were
AIDS, and HIV disease is the term that encompasses all of the independent from those who received supervision or
conditions stagesfrom infection to the deterioration of assistance with transferring, locomotion on unit, dressing,
the immune system and the onset of opportunistic diseases. eating, toilet use, and bathing. (Also see Appendix II, Basic
However, AIDS is still the term most people use to refer to actions difficulty; Complex activity limitation; Instrumental
the immune deficiency caused by HIV. An AIDS diagnosis activities of daily living [IADL]; Limitation of activity.)
indicates that the person has reached the late stages of
the disease and is given to people with HIV who have been AdmissionThe American Hospital Association defines
diagnosed with at least one of a set of opportunistic diseases admissions as persons, excluding newborns, accepted for
or whose laboratory values indicate advanced disease. All 50 inpatient services during the survey reporting period. (Also
states, the District of Columbia (D.C.), and six U.S. dependent see Appendix II, Days of care; Discharge; Inpatient.)
areas (American Samoa, Guam, Northern Mariana Islands,
Puerto Rico, Republic of Palau, and U.S. Virgin Islands) report AgeAge is reported as age at last birthday (i.e., age in
confirmed diagnoses of HIV infection and AIDS cases to CDC completed years), often calculated by subtracting the date
using a uniform surveillance case definition and case report of birth from the reference date, with the reference date
form. The case reporting definitions have changed over time being the date of the examination, interview, or other
to incorporate a broader range of AIDS-indicator diseases contact with an individual.
and conditions and use HIV diagnostic tests to improve
the sensitivity and specificity of the definition. Because of Mothers (maternal) age is reported on the birth certificate
these case definition changes, caution should be used when by all states. Birth statistics are presented for mothers aged
interpreting AIDS trends. (Also see Appendix II, Human 1049 through 1996 and aged 1054 starting in 1997, based
immunodeficiency virus [HIV] disease.) on mothers date of birth or age as reported on the birth
certificate. The age of the mother is edited for upper and
Active physicianSee Appendix II, Physician. lower limits. When the age of the mother is computed to
be under 10 or 55 and over (50 and over in 19641996), it
is considered not stated and is imputed according to the
age of the mother from the previous birth record of the
409 Appendix II. Definitions and Methods Health, United States, 2016
Table I. United States projected year 2000 standard Table I. United States projected year 2000 standard
population and age groups used to age-adjust data population and age groups used to age-adjust data Con.
Data system and age Population Data system and age Population
NHIS, NAMCS, and NHAMCS NAMCS is National Ambulatory Medical Care Survey.
All ages . . . . . . . . . . . . . . . . . . . . . . . . . 274,633,642 NHANES is National Health and Nutrition Examination Survey.
410 Appendix II. Definitions and Methods Health, United States, 2016
Table II. United States projected year 2000 standard population and proportion distribution by age, for age-adjusting
death rates prior to 2001
Proportion
distribution Standard
Age Population (weight) million
SOURCE: NCHS. Anderson RN, Rosenberg HM. Age standardization of death rates: Implementation of the year 2000 standard. National vital statistics reports; vol 47
no 3. Hyattsville, MD: NCHS; 1998. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_03.pdf.
result from age differences in population composition. standard, reflecting the greater weight the 2000 standard
Age-adjusted rates should be viewed as relative indexes gives to the older population, in which race differentials in
rather than actual measures of risk. mortality are smaller.
Age-adjusted rates are calculated by the direct method, as Age-adjusted estimates from any data source presented in
follows: Health, United States that use the projected year 2000 U.S.
n resident population may differ from age-adjusted estimates
ri ( pi / P ) based on the same data presented in other reports if
i=1 different age groups are used in the adjustment procedure.
where
ri = rate in age group i in the population of interest For more information on implementing the 2000 population
pi = standard population in age group i standard for age-adjusting death rates, see: Anderson
n RN, Rosenberg HM. Age standardization of death rates:
P = pi Implementation of the year 2000 standard. National vital
i=1 statistics reports; vol 47 no 3. Hyattsville, MD: NCHS; 1998.
n = total number of age groups over the age Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr47/
range of the age-adjusted rate. nvs47_03.pdf. For more information on the derivation of
age-adjustment weights for use with NCHS survey data, see:
Age adjustment by the direct method requires the use of a Klein RJ, Schoenborn CA. Age adjustment using the 2000
standard age distribution. The standard for age-adjusting projected U.S. population. Healthy People 2010 statistical
death rates and estimates from surveys in Health, United notes, no 20. Hyattsville, MD: NCHS; 2001. Available
States is the projected year 2000 U.S. resident population. from: http://www.cdc.gov/nchs/data/statnt/statnt20.
Starting with Health, United States, 2000, the projected year pdf. The projected year 2000 U.S. standard population is
2000 U.S. standard population replaced the 1970 civilian available from the National Cancer Institutes Surveillance,
noninstitutionalized population for age-adjusting estimates Epidemiology, and End Results (SEER) Program: http://seer.
from most NCHS surveys; and starting with Health, United cancer.gov/stdpopulations/stdpop.singleages.html.
States, 2001, it was used uniformly and replaced the 1940
U.S. population for age-adjusting mortality statistics and the Mortality dataDeath rates are age-adjusted to the
1980 U.S. resident population, which previously had been projected year 2000 U.S. standard population (Table I).
used for age-adjusting estimates from the National Health Prior to 2001 data, age-adjusted rates were calculated
and Nutrition Examination Survey. using standard million proportions based on rounded
population numbers (Table II). Starting with 2001
Changing the standard population has implications for data, unrounded population numbers are used to
racial and ethnic differentials in mortality. For example, the age-adjust. Adjustment is based on 11 age groups,
mortality ratio for the black to white populations is reduced with two exceptions. First, age-adjusted death rates
from 1.6 using the 1940 standard to 1.4 using the 2000 for black males and black females in 1950 are based
411 Appendix II. Definitions and Methods Health, United States, 2016
on nine age groups, with under 1 and 14 combined two weeks. How many times have you had five or more
as one group, and 7584 and 85 and over combined drinks in a row? A drink is defined as a bottle of beer, a
as one group. Second, age-adjusted rates for years of glass of wine, a shot glass of liquor, a mixed drink, etc.
potential life lost before age 75 also use the projected
year 2000 standard population and are based on eight National Survey on Drug Use & Health (NSDUH)
age groups: under 1, 114, 1524, and 10-year age Starting in 2002, NSDUH information about the
groups through 6574. frequency of the consumption of alcoholic beverages
in the past 30 days has been obtained for all persons
National Health and Nutrition Examination Survey surveyed who are aged 12 and over. An extensive list
(NHANES)Estimates based on the National Health of examples of the kinds of beverages covered is given
Examination Survey and NHANES are generally age- to respondents prior to question administration. A
adjusted to the projected year 2000 U.S. standard drink is defined as a can or bottle of beer, a glass of
population by using five age groups: 2034, 3544, wine or a wine cooler, a shot of liquor, or a mixed drink
4554, 5564, and 6574 or 65 and over (Table I). Prior with liquor in it. Those times when the respondent
to Health, United States, 2001, these estimates were had only a sip or two from a drink are not considered
age-adjusted to the 1980 U.S. resident population. consumption. Alcohol use is based on the following
questions: During the past 30 days, on how many
National Health Care SurveysEstimates based on the days did you drink one or more drinks of an alcoholic
National Ambulatory Medical Care Survey, and the beverage?, On the days that you drank during the
National Hospital Ambulatory Medical Care Survey are past 30 days, how many drinks did you usually have?,
age-adjusted to the projected year 2000 U.S. standard and During the past 30 days, on how many days did
population (Table I). Information on the age groups you have five or more drinks on the same occasion? By
used in the age-adjustment procedure is contained in occasion, we mean at the same time or within a couple
the footnotes to the specific tables. of hours of each other.
National Health Interview Survey (NHIS)Estimates Any-listed diagnosisSee Appendix II, Diagnosis.
based on NHIS are age-adjusted to the projected year
2000 U.S. standard population (Table I). Prior to Health, Average annual rate of change (percent change)In
United States, 2000, NHIS estimates were age-adjusted Health, United States, average annual rates of change, or
to the 1970 civilian noninstitutionalized population. growth rates, are calculated as follows:
Information on the age groups used in the age-
adjustment procedure is contained in the footnotes to [(Pn /Po)1/N 1] x 100
the specific tables. where
Pn = later time period
AIDSSee Appendix II, Acquired immunodeficiency Po = earlier time period
syndrome (AIDS). N = number of years in interval.
Alcohol consumptionAlcohol consumption is measured This geometric rate of change assumes that a variable
differently in the following data systems. (Also see Appendix increases or decreases at the same rate during each year
II, Binge drinking.) between the two time periods.
Monitoring the Future (MTF) StudyThis school- Average length of stayThe American Hospital
based survey of secondary school students collects Association computes average length of stay by dividing
information on alcohol use by using self-completed the number of inpatient days by the number of admissions.
questionnaires. To determine whether they have (Also see Appendix II, Days of care; Discharge; Inpatient.)
tried alcohol in their lifetime, students are asked a
preliminary alcohol consumption (defined as beer, Basic actions difficultyBasic actions difficulty is a
wine, liquor, and any other beverage that contains composite measure of disability designed to capture
alcohol) screening question: Have you ever had limitations or difficulties in movement, emotional, sensory,
any alcoholic beverage to drinkmore than just a or cognitive functioning associated with a health problem.
few sips? Students who reply in the affirmative are Persons with more than one of these difficulties are counted
then asked additional questions about their alcohol only once in the estimates. The full range of functional
consumption over different time frames: On how areas cannot be assessed on the basis of National Health
many occasions (if any) have you had alcohol to Interview Survey (NHIS) questions; however, the available
drinkmore than just a few sips in your lifetime, questions can identify difficulty in the following core areas
in the last 12 months, in the last 30 days? A of functioning:
subsequent question asks, Think back over the last
412 Appendix II. Definitions and Methods Health, United States, 2016
Movement (walking, standing, sitting, bending or reply in the affirmative are then asked additional
kneeling, reaching overhead, grasping objects with questions about their alcohol consumption, including
fingers, and lifting). one on binge drinking: Think back over the last two
Selected elements of emotional functioningin weeks. How many times have you had five or more
particular, feelings that interfere with accomplishing drinks in a row? A drink is defined as a bottle of beer,
daily activities. Respondents were classified based a glass of wine, a shot glass of liquor, a mixed drink,
on responses to a series of questions that measure etc. Information on binge drinking is obtained for 12th
psychological distress. graders (starting in 1975) and for 8th and 10th graders
(starting in 1991).
Sensory functioning, based on difficulties seeing or
hearing. National Survey on Drug Use & Health (NSDUH)
Selected elements in cognitive functioning, specifically Starting in 2015, in NSDUH, binge alcohol use is
difficulties with remembering or experiencing defined as drinking five or more drinks on the same
confusion. occasion on at least 1 day in the past 30 days for men.
For women, binge drinking is defined as drinking four
For many measures of disability, only disabilities resulting or more drinks on the same occasion on at least 1 day
from an underlying condition that is chronic (based on in the past 30 days. The threshold for determining
nature and duration) are considered. However, whether binge alcohol use for women was lowered from five
the underlying conditions related to the core areas of basic or more drinks on an occasion for the 2014 and earlier
actions difficulty were chronic was not a requirement in years to four or more drinks on an occasion for 2015.
classifying persons. In Health, United States, respondents Heavy alcohol use is defined as binge drinking on
missing responses in a series of questions were classified as five or more days in the past 30 days. Because heavy
missing for that component. Respondents reporting that alcohol users are also binge alcohol users by definition,
they do not do this activity were classified as missing for estimates of heavy alcohol use among women were
that activity. For hearing, respondents reporting that they also affected by the 2015 redesign. (Also see Appendix
were deaf or had a lot of trouble hearing without the use II, Alcohol consumption.)
of hearing aids or other listening devices were coded as
having a hearing limitation. For more information on how Birth cohortA birth cohort consists of all persons born
this measure was constructed using NHIS data, including within a given period of time, such as a calendar year.
the specific questions asked, see: Altman B, Bernstein A.
Disability and health in the United States, 20012005. Birth rateSee Appendix II, Rate: Birth and related rates.
Hyattsville, MD: NCHS; 2008. Available from: http://www.cdc.
gov/nchs/data/misc/disability2001-2005.pdf. BirthweightBirthweight is the first weight of the newborn
(Also see Appendix II, Complex activity limitation; Hearing obtained after birth. Low birthweight is defined as weighing
trouble.) less than 2,500 grams (5 lb 8 oz). Very low birthweight is
defined as weighing less than 1,500 grams (3 lb 4 oz). Prior
Bed, health facilityThe American Hospital Association to 1979, low birthweight was defined as weighing 2,500
defines bed count as the number of beds, cribs, and grams or less, and very low birthweight as weighing 1,500
pediatric bassinets that are set up and staffed for use grams or less.
by inpatients on the last day of the reporting period. In
the Centers for Medicare & Medicaid Services Quality Blood pressure, highIn Health, United States, a person
Improvement Evaluation System (QIES) (formerly the Online is considered to have hypertension if they have measured
Survey Certification and Reporting [OSCAR]) database, high blood pressure (i.e., average measured systolic blood
all beds in certified facilities are counted on the day of pressure of at least 140 mm Hg or diastolic pressure of at
certification inspection. (Also see Appendix II, Hospital; least 90 mm Hg) and/or if they report that they are taking a
Occupancy rate.) prescription medicine for high blood pressure (respondents
were asked, Are you now taking prescribed medicine for
Binge drinkingBinge drinking is measured in the your high blood pressure?). Uncontrolled high blood
following data systems. (Also see Appendix II, Alcohol pressure is defined as having an average measured systolic
consumption.) blood pressure of at least 140 mm Hg or diastolic pressure
of at least 90 mm Hg, among those with hypertension.
Monitoring the Future (MTF) StudyThis school- Those with uncontrolled high blood pressure also may be
based survey of secondary school students collects taking prescribed medicine for high blood pressure. These
information on alcohol use by using self-completed blood pressure definitions are consistent with the following:
questionnaires. To determine whether they have tried National Heart, Lung, and Blood Institute. Seventh report
alcohol, students are asked a preliminary screening of the Joint National Committee on Prevention, Detection,
question: Have you ever had any alcoholic beverage Evaluation, and Treatment of High Blood Pressure. NIH pub
to drinkmore than just a few sips? Students who no 045230. Bethesda, MD: National Institutes of Health;
413 Appendix II. Definitions and Methods Health, United States, 2016
2004. Available from: http://www.nhlbi.nih.gov/guidelines/ in the prevalence, awareness, treatment, and control of
hypertension/jnc7full.pdf; and Go AS, Bauman M, King hypertension in the adult U.S. population: Data from the
SMC, Fonarow GC, Lawrence W, Williams KA, et al. AHA/ health examination surveys, 1960 to 1991. Hypertension
ACC/CDC. An effective approach to high blood pressure 1995;26(1):609.
control: A science advisory from the American Heart
Association, the American College of Cardiology, and the Body mass index (BMI)BMI is a measure that adjusts
Centers for Disease Control and Prevention. Hypertension body weight for height. It is calculated as weight in
2014;63(4):878-85. Available from: https://www.ncbi.nlm.nih. kilograms divided by height in meters squared. Normal
gov/pubmed/24243703. weight for adults is defined as a BMI of 18.5 to less than
25.0; overweight or obese is greater than or equal to 25.0;
Blood pressure data presented in Health, United States are and obesity is greater than or equal to 30.0. Within the
from the National Health and Nutrition Examination Survey obesity category, Grade 1 obesity is defined as a BMI of
(NHANES). Blood pressure is measured by averaging up 30.0 to less than 35.0; Grade 2 is 35.0 to less than 40.0; and
to three blood pressure readings taken for an NHANES Grade 3 is 40.0 or greater. Prior to assigning a person to
participant. Blood pressure readings of 0 mm Hg are not a BMI category, BMI is rounded to one decimal place. In
included in the estimates. The methods used to measure Health, United States, the NHANES variable Body Mass Index
the blood pressure of participants have changed over is used to assign persons to BMI categories. BMI cut points
the different NHANES survey years. Changes include the are defined in the following: National Heart, Lung, and
following: Blood Institute. Managing overweight and obesity in adults:
Systematic evidence review from the Obesity Expert Panel.
Number of blood pressure measurements taken Bethesda, MD: National Institutes of Health; 2013. Available
(increased from one to four). from: https://www.nhlbi.nih.gov/health-pro/guidelines/
Equipment maintenance procedures. in-develop/obesity-evidence-review; Jensen MD, Ryan DH,
Training of persons taking readings (physician, nurse, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013
AHA/ACC/TOS guideline for the management of overweight
or interviewer).
and obesity in adults: A report of the American College
Proportion zero end-digits for systolic and diastolic of Cardiology/American Heart Association Task Force on
readings. Practice Guidelines and the Obesity Society. Circulation;
Published diastolic definition. 2014;129(25 Suppl 2):S102-38. Available from: https://www.
ncbi.nlm.nih.gov/pubmed/24222017; and HHS. Healthy
Location where the measurements were taken (mobile People 2020: Nutrition, physical activity, and obesity; 2012.
examination center [MEC] or home). Available from: http://www.healthypeople.gov/2020/
Leading-Health-Indicators. MEC weights were used to
In 1999 and subsequent years, blood pressure has been obtain estimates, and pregnant females were excluded. For
measured in the NHANES MEC by one of the MEC physicians. 19881994 estimates for adults, almost 500 persons had
For people aged 8 and over, three consecutive blood an abbreviated exam in their home instead of going to the
pressure readings are obtained using the same arm. If MEC. The MEC+home weight was used to include these
a blood pressure measurement was interrupted or the persons in the estimates.
measurer was unable to get one or more of the readings,
a fourth attempt may be made. Both systolic and diastolic Obesity for children and adolescents is defined as a BMI
measurements are recorded to the nearest even number. at or above the sex- and age-specific 95th percentile
from the 2000 CDC Growth Charts (http://www.cdc.gov/
In NHANES III, three sets of blood pressure measurements growthcharts/). The age used is age in months from the
were taken in the MEC for examinees aged 5 and over. age at time of examination. Also see, Kuczmarski RJ, Ogden
Blood pressure measurements were also taken by trained CL, Guo SS, et al. 2000 CDC Growth Charts for the United
interviewers during the household interview, on sample States: methods and development. Vital Health Stat 11.
persons aged 17 and over. Systolic and diastolic average 2002 May; (246):1190. Available at: http://www.cdc.gov/
blood pressures were computed as the arithmetic mean nchs/data/series/sr_11/sr11_246.pdf. MEC weights were
of six or fewer measurements obtained at the household used to obtain estimates, and pregnant girls were excluded.
interview (maximum of three) and the MEC examination Starting with Health, United States, 2010, the terminology
(maximum of three). If the examinee did not have blood describing excess weight among children changed from
pressure measurements taken in the MEC, this variable was previous editions. The term obesity now refers to children
calculated from measurements taken at the household who were formerly labeled as overweight. This is a change
interview. Both systolic and diastolic measurements were in terminology only and not a change in measurement. For
recorded to the nearest even number. more information, see: Ogden CL, Flegal KM. Changes in
terminology for childhood overweight and obesity. National
For more information on changes in blood pressure health statistics report; no 25. Hyattsville, MD: NCHS; 2010.
measurement in NHANES up to 1991, see: Burt VL, Cutler JA, Available from: http://www.cdc.gov/nchs/data/nhsr/
Higgins M, Horan MJ, Labarthe D, Whelton P, et al. Trends nhsr025.pdf.
414 Appendix II. Definitions and Methods Health, United States, 2016
Table III. Revision of the International Classification of Cause-of-death rankingSelected causes of death of
Diseases (ICD), by year of conference in which adopted public health and medical importance are compiled into
and years in use in the United States tabulation lists and are ranked according to the number of
deaths assigned to these causes. The top-ranking causes
Year of Years in
conference by use in determine the leading causes of death. Certain causes
ICD revision which adopted United States on the tabulation lists are not ranked if, for example, the
category title represents a group title (such as Major
1st . . . . . . . . . . . . . . . . 1900 19001909
cardiovascular diseases and Symptoms, signs, and
2nd . . . . . . . . . . . . . . . 1909 19101920
3rd . . . . . . . . . . . . . . . 1920 19211929
abnormal clinical and laboratory findings, not elsewhere
4th. . . . . . . . . . . . . . . . 1929 19301938 classified) or the category title begins with the words
5th. . . . . . . . . . . . . . . . 1938 19391948 Other or All other. In addition, when one of the titles that
6th. . . . . . . . . . . . . . . . 1948 19491957 represents a subtotal (such as Malignant neoplasms) is
7th. . . . . . . . . . . . . . . . 1955 19581967 ranked, its component parts are not ranked. The tabulation
8th. . . . . . . . . . . . . . . . 1965 19681978 lists used for ranking in the 10th revision of the International
9th. . . . . . . . . . . . . . . . 1975 19791998 Classification of Diseases (ICD10) include the List of 113
10th . . . . . . . . . . . . . . . 1990 1999present
Selected Causes of Death, which replaces the ICD9 List of
72 Selected Causes, HIV Infection and Alzheimers Disease;
SOURCE: NCHS. Available from: https://www.cdc.gov/nchs/icd/icd9.htm.
and the ICD10 List of 130 Selected Causes of Infant Death,
Cause of deathFor the purpose of national mortality which replaces the ICD9 List of 60 Selected Causes of Infant
statistics, every death is attributed to one underlying Death and HIV Infection. Causes that are tied receive the
condition, based on information reported on the death same rank; the next cause is assigned the rank it would have
certificate and using the international rules for selecting received had the lower-ranked causes not been tied, that
the underlying cause of death from the conditions stated is, a rank is skipped. For more information, see the annual
on the certificate. The underlying cause is defined by the series of Deaths: Final Data and Deaths: Leading Causes
World Health Organization (WHO) as the disease or injury reports, available from: http://www.cdc.gov/nchs/products/
that initiated the train of events leading directly to death, or nvsr.htm. (Also see Appendix II, International Classification of
the circumstances of the accident or violence that produced Diseases [ICD].)
the fatal injury. Generally, more medical information is
reported on death certificates than is directly reflected Childrens Health Insurance Program (CHIP)Title XXI of
in the underlying cause of death. Conditions that are not the Social Security Act, often referred to as the Childrens
selected as the underlying cause of death constitute the Health Insurance Program (CHIP), is a program originally
nonunderlying causes of death, also known as multiple enacted by the Balanced Budget Act of 1997. The Childrens
cause of death. Health Insurance Program Reauthorization Act of 2009
(CHIPRA, P.L. 1113) reauthorized CHIP and appropriated
Cause of death is coded according to the appropriate funding for CHIP through FY 2013. The Affordable Care
revision of the International Classification of Diseases (ICD) Act of 2010 (ACA, P.L. 111148) extends CHIP funding
(Table III). Effective with deaths occurring in 1999, the United through FY 2015, and the Medicare Access and CHIP
States began using the 10th revision of the ICD (ICD10); Reauthorization Act of 2015 (P.L. 11410) extended funding
during the period 19791998, causes of death were coded with no programmatic changes for CHIP through 2017.
and classified according to the 9th revision (ICD9). Table IV CHIP provides federal funds for states to provide health care
lists ICD codes for the 6th through 10th revisions for causes coverage to eligible low-income, uninsured children whose
of death shown in Health, United States. In Health, United income is too high to qualify for Medicaid. Generally, CHIP
States, common terms are sometimes used in the text in is only available through age 18. CHIP gives states broad
place of medical terminology. Examples include cancer for flexibility in program design within a federal framework
malignant neoplasm and kidney disease for Nephritis, that includes important beneficiary protections. Funds from
nephrotic syndrome, and nephrosis. CHIP may be used for a separate child health program or to
expand Medicaid. Although CHIP is not part of Medicaid, in
Each ICD revision has produced discontinuities in cause-of some instances in Health, United States, data on CHIP and
death trends. These discontinuities are measured by using Medicaid are presented together, and those instances are
comparability ratios that are essential to the interpretation discussed in the footnotes of the respective tables. For more
of mortality trends. For further discussion, see: http://www. information, see: https://www.medicaid.gov/chip/chip
cdc.gov/nchs/nvss/mortality/comparability_icd.htm. program-information.html. (Also see Appendix II, Health
(Also see Appendix II, Comparability ratio; International insurance coverage; Medicaid.)
Classification of Diseases [ICD]; and Appendix I, National Vital
Statistics System [NVSS]; Multiple Cause-of-Death File.) CholesterolSerum total cholesterol is a combination
of high-density lipoprotein (HDL) cholesterol, low-density
lipoprotein (LDL) cholesterol, and very low-density
lipoprotein (VLDL) cholesterol and is highly correlated
415 Appendix II. Definitions and Methods Health, United States, 2016
Table IV. Cause-of-death codes, by applicable revision of the International Classification of Diseases (ICD)
416 Appendix II. Definitions and Methods Health, United States, 2016
Table IV. Cause-of-death codes, by applicable revision of the International Classification of Diseases (ICD)Con.
. . . Cause-of-death codes are not provided for causes not shown in Health, United States.
1
Categories for coding human immunodeficiency virus (HIV) infection were introduced in 1987. The asterisk (*) indicates codes that are not part of ICD9.
2
Starting with 2001 data, NCHS introduced categories *U01*U03 for classifying and coding deaths due to acts of terrorism. The asterisk (*) indicates codes that are not
part of ICD10. Starting with 2007 data, NCHS introduced the category J09 for coding avian influenza virus. In 2009, the title for the ICD10 code J09 was changed
from Influenza due to identified avian influenza virus to Influenza due to certain identified influenza virus. This change was made to accommodate deaths from influenza
A (H1N1) virus in the ICD10 code J09 for data years 2009 and beyond.
3
In the public health community, the term unintentional injuries is preferred to accidents, and the term motor vehicle-related injuries is preferred to motor vehicle accidents.
SOURCE: NCHS. Advance report: Final mortality statistics, 1974. Monthly vital statistics report; vol 24 no 11 suppl. Hyattsville, MD: NCHS; 1976. Available from:
http://www.cdc.gov/nchs/data/mvsr/supp/mv24_11sacc.pdf. Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final data for 1997. National vital statistics reports; vol 47
no 19. Hyattsville, MD: NCHS; 1999. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_19.pdf. Hoyert DL, Heron MP, Murphy SL, Kung H-C. Deaths:
Final data for 2003. National vital statistics reports; vol 54 no 13. Hyattsville, MD: NCHS; 2006. Available from:
http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_13.pdf. Murphy SL, Xu JQ, Kochanek KD. Deaths: Final data for 2010. National vital statistics reports; vol 61 no 4.
Hyattsville, MD: NCHS; 2013. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf. Murphy SL, Kochanek KD, Xu JQ, Curtin SC. Deaths: Final
data for 2015. National vital statistics reports. Hyattsville, MD: NCHS; 2017. Available from: https://www.cdc.gov/nchs/products/nvsr.htm.
417 Appendix II. Definitions and Methods Health, United States, 2016
with LDL cholesterol. High serum total cholesterol is lipid analyses. Serum total cholesterol was measured on all
a risk factor for cardiovascular disease (see Wilson PW, examined adults regardless of whether they had fasted, and
DAgostino RB, Levy D, Belanger AM, Silbershatz H, Kannel data were analyzed regardless of fasting status. Cholesterol
WB. Prediction of coronary heart disease using risk factor measurements are standardized according to the criteria
categories. Circulation 97(18):183747. 1998). In its 2002 of CDCand later the CDCNational Heart, Lung, and
report on high blood cholesterol, the National Cholesterol Blood Institute Cholesterol Standardization Programto
Education Program Expert Panel on Detection, Evaluation, ensure comparable and accurate measurements. For more
and Treatment of High Blood Cholesterol in Adults (Adult information, see: Myers GL, Cooper GR, Winn CL, Smith
Treatment Panel III, or ATP III) considered a serum total SJ. The Centers for Disease ControlNational Heart, Lung,
cholesterol value greater than or equal to 240 mg/dL (6.20 and Blood Institute Lipid Standardization Program: An
mmol/L) as high. A more recent set of guidelinesthe result approach to accurate and precise lipid measurements.
of a collaboration among the National Heart, Lung, and Clin Lab Med 1989;9(1):10535. A detailed summary of
Blood Institute; the American College of Cardiology; and the procedures used for measurement of total cholesterol
the American Heart Associationfocused on which groups in the earlier NHANES survey years has been published
of people could benefit from statin use, based on their risk in: Carroll MD, Kit BK, Lacher DA, Shero ST, Mussolino ME.
factors. Because Health, United States focuses on providing Trends in lipids and lipoproteins in US adults, 19882010.
population-level prevalence data rather than individual- JAMA 2012;308(15):154554. A description of the laboratory
level estimates, three broad indicators of cholesterol are procedures for the total cholesterol measurement for
presented based on measured serum total cholesterol level different NHANES survey years is published by NCHS and is
and the reported use of cholesterol-lowering medications. available from: http://www.cdc.gov/nchs/nhanes.htm.
Cholesterol levels are determined using the NHANES
T_CHOL file. For more information on the current cholesterol Cigarette smokingCigarette smoking and related
guidelines, see: Management of blood cholesterol in tobacco use are measured in the following data systems.
adults: Systematic evidence review from the Cholesterol
Expert Panel. Bethesda, MD: National Institutes of Health, Monitoring the Future (MTF) StudyInformation on
National Heart, Lung, and Blood Institute; 2013. Available current cigarette smoking was obtained for 12th
from: http://www.nhlbi.nih.gov/health-pro/guidelines/in graders (starting in 1975) and for 8th and 10th graders
develop/cholesterol-in-adults; and Stone NJ, Robinson JG, (starting in 1991), based on the following question:
Lichtenstein AH, Merz CNB, Blum CB, Eckel RH, et al. 2013 How frequently have you smoked cigarettes during
ACC/AHA guideline on the treatment of blood cholesterol to the past 30 days? Information on e-cigarette use was
reduce atherosclerotic cardiovascular risk in adults: A report obtained for 8th, 10th, and 12th graders (starting in
of the American College of Cardiology/American Heart 2014), based on the following question: During the
Association Task Force on Practice Guidelines. Circulation. last 30 days, on how many days (if any), have you used
2014;129:S145. Available from: http://circ.ahajournals.org/ electronic cigarettes (e-cigarettes)?
content/129/25_suppl_2/S1.full.
National Health Interview Survey (NHIS)Information
In Health, United States, three measures of total cholesterol about cigarette smoking is obtained for adults aged
are presented: hypercholesterolemia, high serum 18 and over. Starting in 1993, current smokers are
total cholesterol, and mean serum total cholesterol. identified by asking the following two questions:
Hypercholesterolemia is based on both laboratory testing Have you smoked at least 100 cigarettes in your entire
and self-reported medication use. It is defined as measured life? and Do you now smoke cigarettes every day,
serum total cholesterol greater than or equal to 240 some days, or not at all? Persons who smoked 100
mg/dL or reporting taking cholesterol-lowering cigarettes and who now smoke every day or some
medications. Respondents who were told by a doctor or days were defined as current smokers. Before 1992,
health professional that their cholesterol was high, and were current smokers were identified based on positive
told by a doctor to take cholesterol-lowering medication responses to the following two questions: Have you
and who answered yes to the question, Are you now smoked 100 cigarettes in your entire life? and Do
following this advice? were classified as taking cholesterol- you smoke now? (traditional definition). In 1992, the
lowering medication. High serum total cholesterol is defined definition of current smoker in NHIS was modified to
as measured serum total cholesterol greater than or equal separately identify persons who smoked every day and
to 240 mg/dL (6.20 mmol/L). Both high serum cholesterol those who smoked on some days (revised definition).
and mean serum total cholesterol are based on serum In 1992, cigarette smoking data were collected for
samples collected during the National Health and Nutrition a half-sample, with one-half of respondents (one
Examination Survey (NHANES) examination. quarter sample) answering the traditional smoking
questions and the other one-half (one-quarter
Venous blood serum samples collected from NHANES sample) answering the revised smoking question, Do
participants at mobile examination centers were frozen you smoke every day, some days, or not at all? An
and shipped on dry ice to the laboratory conducting the unpublished analysis of the 1992 traditional smoking
418 Appendix II. Definitions and Methods Health, United States, 2016
measure revealed that the crude percentage of current were asked two separate questions: Have you ever had a
smokers aged 18 and over remained the same as colonoscopy? and Have you ever had a sigmoidoscopy?
for 1991. The estimates for 1992 shown in Health, An additional question about colorectal testing, Have you
United States combine data collected using both the ever had a blood stool test using a home testing kit? was
traditional and revised questions. Estimates for 1993 asked in all of these survey years.
and beyond use the revised questions.
Respondents who replied that they had a colorectal test
In 19931995, estimates of cigarette smoking or procedure were asked subsequent questions about
prevalence were based on a half-sample. Smoking the month, year, and time since their most recent test or
data were not collected in 1996. Starting in 1997, procedure. In 2000 and 2003, if respondents did not provide
smoking data were collected in the Sample Adult the year of, or the time since, their most recent colorectal
questionnaire. Starting in 2014, a question was added exam, they were asked about the time frame of their most
to the survey on the use of electronic cigarettes, often recent exam (i.e., whether they had the exam a year ago or
referred to as e-cigarettes. Electronic cigarette use was less, more than 1 year ago but not more than 2 years ago,
not considered in the definition of current cigarette more than 2 years ago but not more than 3 years ago, more
smoking. For more information on e-cigarette use, than 3 years ago but not more than 5 years ago, more than
see: Schoenborn CA, Gindi RM. Electronic cigarette use 5 years ago but not more than 10 years ago, or over 10 years
among adults: United States, 2014. NCHS data brief, ago). For adults who provided the year, but not the month,
no 217. Hyattsville, MD: NCHS. 2015. Available from: of their most recent exam, the exam date was coded as July
http://www.cdc.gov/nchs/data/databriefs/db217. 15 of the provided year.
htm. For more information on survey methodology
and sample sizes pertaining to NHIS cigarette smoking In 2005, 2008, 2010, 2013, and 2015, the questionnaire
data, see the NHIS Adult Tobacco Use Information skip pattern was modified so that respondents giving
website at: http://www.cdc.gov/nchs/nhis/tobacco. an incomplete or partial date (missing month or year) of
htm. their most recent colorectal exam were asked a follow-up
question about the time since their most recent exam (i.e.,
National Survey on Drug Use & Health (NSDUH) whether they had the exam a year ago or less, more than 1
Information on current cigarette smoking is obtained year ago but not more than 2 years ago, more than 2 years
for all persons surveyed who are aged 12 and over, ago but not more than 3 years ago, more than 3 years ago
based on the following question: Now think about the but not more than 5 years ago, more than 5 years ago but
past 30 days, that is, from [DATE] up to and including not more than 10 years ago, or over 10 years ago). In 2015,
today. During the past 30 days, have you smoked the home FOBT questions were modified to include fecal
part or all of a cigarette? Electronic cigarette use was immunochemical tests (FITs)a type of FOBT (Have you
not considered in the definition of current cigarette ever had a blood stool or FIT test, using a home test kit?).
smoking. In 2010 and 2015, additional questions on the use of virtual
or CT colonoscopy were included in the questionnaire,
Civilian noninstitutionalized population; Civilian but these questions were not used to determine whether
populationSee Appendix II, Population. respondents had a colorectal test or procedure in Health,
United States.
Colorectal tests or proceduresColorectal tests or
procedures are used to detect polyps, abnormal cell growth, In Health, United States, adults aged 5075 were considered
lesions, and other gastrointestinal conditions, including to have any colorectal test or procedure if they met the
colon cancer. These tests may include home fecal occult screening guidelines made by the U.S. Preventive Services
blood tests (FOBT), sigmoidoscopy, or colonoscopy. The time Task Force (USPSTF) in 2008. These adults either reported (1)
interval between screenings varies, depending on the type a home fecal occult blood test (FOBT) in the past year, (2) a
of test as well as individual risk factors and prior screening sigmoidoscopy procedure in the past 5 years with FOBT in
history. the past 3 years, or (3) a colonoscopy in the past 10 years.
In the National Health Interview Survey, questions about The current USPSTF recommendationsmade in 2016
colorectal tests or procedures were asked of respondents have not been applied to Health, United States estimates.
aged 40 and over on an intermittent schedule, and the These guidelines recommend the use of screening in adults
questions varied over time. Colorectal screening tests aged 50 to 75. Frequency of screening varies by test and
and procedures may be used for diagnostic or screening procedure, and recommend strategies include: (1) annual
purposes, but the purpose cannot be determined from NHIS. or biennial screening with guaiac-based FOBT (gFOBT) in
addition to flexible sigmoidoscopy every 3 to 5 years, (2)
In 2000, 2003, 2005, and 2008, respondents were asked, annual screening with FITs, (3) screening every 10 years
Have you ever had a sigmoidoscopy, colonoscopy, or with colonoscopy, or (4) screening every 5 years with CT
proctoscopy? In 2010, 2013, and 2015, respondents colography. The recommendation does not emphasize a
419 Appendix II. Definitions and Methods Health, United States, 2016
particular screening approach, as the risks and benefits Table V. Comparability of selected causes of death
may vary. For a summary of current colorectal screening between the 9th and 10th revisions of the International
recommendations and the status of the review, see: http:// Classification of Diseases (ICD)
www.uspreventiveservicestaskforce.org/Page/Document/
Final
UpdateSummaryFinal/colorectal-cancer-screening2. comparability
Cause of death 1 ratio 2
Community hospitalSee Appendix II, Hospital. Human immunodeficiency virus (HIV)
disease . . . . . . . . . . . . . . . . . . . . . . . . 1.0821
Comparability ratioAbout every 10 to 20 years, the Malignant neoplasms . . . . . . . . . . . . . . . . 1.0093
International Classification of Diseases (ICD) is revised to Colon, rectum, and anus . . . . . . . . . . . . 0.9988
stay abreast of advances in medical science and changes Trachea, bronchus, and lung . . . . . . . . . . 0.9844
in medical terminology. Each of these revisions produces Breast . . . . . . . . . . . . . . . . . . . . . . . . 1.0073
breaks in the continuity of cause-of-death statistics because Prostate . . . . . . . . . . . . . . . . . . . . . . . 1.0144
Diabetes mellitus . . . . . . . . . . . . . . . . . . . 1.0193
of changes in classification and in the rules for selecting an
Alzheimer's disease . . . . . . . . . . . . . . . . . 1.5812
underlying cause of death. Classification and rule changes Diseases of heart . . . . . . . . . . . . . . . . . . . 0.9852
affect cause-of-death trend data by shifting deaths away Ischemic heart diseases . . . . . . . . . . . . . 1.0006
from some cause-of-death categories and into others. Essential (primary) hypertension and
Comparability ratios measure the effect of changes in hypertensive renal disease . . . . . . . . . . . . 1.1162
classification and coding rules. For the causes shown in Table Cerebrovascular diseases . . . . . . . . . . . . . 1.0502
Influenza and pneumonia . . . . . . . . . . . . . . 0.6974
V, comparability ratios range between 0.6974 and 1.5812.
Chronic lower respiratory diseases . . . . . . . . 1.0411
Influenza and pneumonia had the lowest comparability ratio Chronic liver disease and cirrhosis . . . . . . . . 1.0321
(0.6974), indicating that this cause is about 30% less likely to Nephritis, nephrotic syndrome, and
be selected as the underlying cause of death under ICD10 nephrosis . . . . . . . . . . . . . . . . . . . . . . . 1.2555
than under ICD9. Alzheimers disease had the highest Pregnancy, childbirth, and the puerperium . . . 1.1404
comparability ratio (1.5812), indicating that Alzheimers Unintentional injuries . . . . . . . . . . . . . . . . 1.0251
Motor vehicle-related injuries . . . . . . . . . . 0.9527
disease is 58% more likely to be selected as the underlying
Poisoning . . . . . . . . . . . . . . . . . . . . . . 1.0365
cause when ICD10 coding is used. Suicide . . . . . . . . . . . . . . . . . . . . . . . . . 1.0022
Homicide. . . . . . . . . . . . . . . . . . . . . . . . 1.0020
For selected causes of death, the ICD9 codes used to Firearm-related injury . . . . . . . . . . . . . . . . 1.0012
calculate death rates for 19801998 differ from the ICD9 Chronic and noncommunicable diseases . . . . 1.0100
codes most nearly comparable with the corresponding ICD Injuries . . . . . . . . . . . . . . . . . . . . . . . . . 1.0159
10 cause-of-death category, which also affects the ability to
compare death rates across ICD revisions. Examples of these 1
2
See Table IV for ICD9 and ICD10 cause-of-death codes.
Minio AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. Deaths:
ICD9 codes that are more comparable with codes for Injuries, 2002. National vital statistics reports; vol 54 no 10. Hyattsville, MD:
corresponding ICD10 categories. Table IV shows the ICD9 NCHS; 2006. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr54/
nvsr54_10.pdf.
420 Appendix II. Definitions and Methods Health, United States, 2016
Available from: http://www.cdc.gov/nchs/data/nvsr/ in the United States, 20012005. Hyattsville, MD: NCHS;
nvsr49/nvsr49_02.pdf; Kochanek KD, Smith BL, Anderson 2008. Available from: http://www.cdc.gov/nchs/data/misc/
RN. Deaths: Preliminary data for 1999. National vital disability2001-2005.pdf. (Also see Appendix II, Activities
statistics reports; vol 49 no 3. Hyattsville, MD: NCHS; 2001. of daily living [ADL]; Basic actions difficulty; Instrumental
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr49/ activities of daily living [IADL].)
nvsr49_03.pdf; Final ratios for 113 selected causes of death,
available from: ftp://ftp.cdc.gov/pub/Health_Statistics/ Consumer Price Index (CPI)The CPI, prepared by the
NCHS/Datasets/Comparability/icd9_icd10/; and the ICD U.S. Bureau of Labor Statistics, is a monthly measure of the
comparability ratio website at: http://www.cdc.gov/nchs/ average change in prices of goods and services purchased
nvss/mortality/comparability_icd.htm. (Also see Appendix II, by urban households. The medical care component of the
Cause of death; International Classification of Diseases [ICD].) CPI shows trends in medical care prices based on specific
indicators of hospital, medical, and drug prices. A revised
CompensationSee Appendix II, Employer costs for definition of the CPI has been in use since January 1988.
employee compensation. (Also see Appendix II, Gross domestic product [GDP]; and
Health expenditures, national.)
Complex activity limitationComplex activity limitation
is a composite measure of disability constructed to measure ContraceptionThe National Survey of Family Growth
disability as defined by the inability to function successfully collects information on contraceptive use as reported by
in certain social roles. Complex activities consist of the tasks women aged 1544. To determine current contraceptive
and organized activities that make up a number of social use, women were asked to identify up to four, out of 21,
roles, such as working, maintaining a household, living contraceptive methods they had used during the month of
independently, and participating in community activities. interview. In the 20112015 NSFG, these methods included
Complex activity performance requires the execution of a birth control pills, condoms, male sterilization, female
combination of core areas of functioning. Complex activities sterilization, withdrawal, injectables, hormonal implants,
include the following: calendar rhythm, natural family planning, diaphragm, female
Maintaining independence, including self-care and condoms, foams, jelly or creams, cervical caps, suppositories
the ability to carry out activities associated with or inserts, sponge, intrauterine device, emergency
maintaining a household, such as shopping, cooking, contraception, contraceptive patches, vaginal contraceptive
and taking care of bills. (Measures are based on rings, or other methods.
questions commonly known as activities of daily
living [ADLs] and instrumental activities of daily living Cost to charge ratioThe Agency for Healthcare Research
[IADLs].) Limitations in these activities usually reflect and Qualitys Healthcare Cost and Utilization Project (HCUP)
severe restrictions and are associated with limitations contains data on total charges per discharge as reported
in other complex activities. on the hospital discharge record. This charge information
represents the amount the hospital billed for services but
Difficulties experienced with social and leisure does not reflect how much hospital services actually cost
activitiesrepresented in this measure by attending or the specific amounts that hospitals received in payment.
movies or sporting events, visiting friends, or pursuing Data on costs may be of more interest to some users. The
hobbies or relaxation activities. HCUP Cost-to-Charge ratio files convert charges to costs.
Perceived limitation in the ability to work (a core aspect Each file contains hospital-specific cost-to-charge ratios
of social participation for the majority of the U.S. based on all-payer inpatient cost for nearly every hospital
population)represented by the respondents self- in HCUP. Cost information was obtained from hospital cost
defined limitation in the kind or amount of work they reports collected by the Centers for Medicare & Medicaid
can do or their inability to work at a job or business. Services. Some imputations for missing values were
necessary. These files are unique by year.
For many measures of disability, only disabilities resulting
from an underlying condition that is chronic (based on Critical access hospitalSee Appendix II, Hospital.
nature and duration) are considered. However, whether
the underlying conditions related to the complex activities Crude birth rate; Crude death rateSee Appendix II, Rate:
were chronic was not a requirement in classifying persons as Birth and related rates; Rate: Death and related rates.
having a complex activity limitation. In Health, United States,
respondents missing responses in a series of questions Days of careDays of care is defined by the American
were classified as missing for that component. Respondents Hospital Association as the number of adult and pediatric
reporting that they do not do this activity were classified days of care rendered during the entire reporting period.
as missing for that activity. For more information on how Days of care for newborns are excluded. (Also see Appendix
this measure was constructed using data from the National II, Admission; Average length of stay; Discharge; Hospital;
Health Interview Survey, including the specific questions Hospital utilization; Inpatient.)
asked, see: Altman B, Bernstein A. Disability and health
421 Appendix II. Definitions and Methods Health, United States, 2016
Death rateSee Appendix II, Rate: Death and related rates. how long it had been since they last saw a dentist. Questions
about dental visits were not asked for children under age
Dental cariesDental caries is evidence of decay on the 2 for years 19971999 and under age 1 for years 2000 and
crown or enamel surface of a tooth (i.e., coronal caries) and beyond. Starting with 1997 data, estimates are presented for
includes treated and untreated caries. Untreated dental people with a dental visit in the past year.
caries refers to decay on the crown or enamel surface of a
tooth (i.e., coronal caries) that has not been treated or filled. DiabetesDiabetes is a group of conditions in which
Decay in the root (i.e., root caries) was not included. insulin is not adequately secreted or utilized. Diabetes
is a leading cause of disease and death in the United
In Health, United States, estimates on the presence of caries States. Using data from the National Health and Nutrition
are based on evaluation of primary and permanent teeth Examination Survey (NHANES), three measures of diabetes
for persons aged 5 and over. The third molars were not are presented in Health, United States: physician-diagnosed
included. Persons without at least one natural tooth (primary diabetes, undiagnosed diabetes, and total diabetes.
or permanent) were classified as edentulous (without any Physician-diagnosed diabetes data were obtained by self-
teeth) and were excluded. The majority of edentulous report. Respondents who answered yes to the question,
persons are aged 65 and over. Estimates of edentulism Other than during pregnancy, have you ever been told
among persons aged 65 and over are 33% in 19881994, by a doctor or health professional that you have diabetes
23% in 20052008, and 17% in 20112014. or sugar diabetes? were classified as having physician-
diagnosed diabetes.
Dental caries was identified by an oral examination as part
Only respondents who were not classified as having
of the National Health and Nutrition Examination Survey
physician-diagnosed diabetes were evaluated to determine
(NHANES). Over time, there have been changes in the
if they had undiagnosed diabetes. Undiagnosed diabetes
NHANES oral health examination process, ages examined,
was based on the results of laboratory testing of whole
and methodology. During 19881994, a full-mouth
blood and blood plasma samples collected from NHANES
complete oral health exam was conducted by a trained
participants at mobile examination centers. Undiagnosed
dentist on those aged 1 and over. During 19992004, a
diabetes was defined as a fasting plasma glucose (FPG) of
full-mouth complete oral health exam was conducted by a
at least 126 mg/dL or a hemoglobin A1c of at least 6.5%
trained dentist on those aged 2 and over. During 20052008,
and no reported physician diagnosis. Respondents had
data were collected for those aged 5 and over by a trained
fasted for at least 8 hours and less than 24 hours at the
health technologist using the Basic Screening Examination
time of the blood draw. Fasting is not necessary to measure
(BSE), a simplified screening process to collect information
hemoglobin A1c. However, to be consistent with the
on untreated caries, dental restorations, and dental sealants.
subsample of fasting respondents used for FPG, assessment
During 20092010, the BSE was conducted by a trained
of undiagnosed diabetes in Health, United States is limited
dental hygienist on those aged 319. No data on adults were
to the fasting subsample. Total diabetes includes those who
collected. During 20052008 and 20092010, the use of the
were classified as having either physician-diagnosed or
BSE does not allow us to determine if untreated decay was
undiagnosed diabetes. Fasting weights were used to obtain
found in permanent teeth or primary teeth. For
prevalence estimates, and pregnant women were excluded.
20112014 data, a full-mouth complete oral health exam
was conducted by a trained dentist on those aged 1 and
Starting with Health, United States, 2010, an elevated
over.
hemoglobin A1c (greater than or equal to 6.5%) was
included as a component of the definition of undiagnosed
For more information, see: Dye BA, Barker LK, Li X, Lewis diabetes, along with FPG. Previous editions of Health,
BG, Beltrn-Aguilar ED. Overview and quality assurance United States did not evaluate hemoglobin A1c to classify
for the oral health component of the National Health respondents as having undiagnosed diabetes; undiagnosed
and Nutrition Examination Survey (NHANES), 200508. J diabetes was based solely on elevated FPG (greater than
Public Health Dent 2011;71(1):5461; and the following or equal to 126 mg/dL) among those without physician-
NHANES resources: https://wwwn.cdc.gov/nchs/ diagnosed diabetes. The revised definition of undiagnosed
nhanes/2007-2008/OHX_E.htm, https://wwwn.cdc.gov/ diabetes was based on recommendations from the
nchs/nhanes/2009-2010/OHXDEN_F.htm, and https:// American Diabetes Association (ADA). Hemoglobin A1c
wwwn.cdc.gov/Nchs/Nhanes/2013-2014/OHXDEN_H.htm. was recommended as a component in diagnosing diabetes
because recent improvements in assay standardization
Dental visitStarting in 1997, National Health Interview make A1c results more reliable. In addition, research
Survey respondents were asked, About how long has it has provided evidence linking elevated A1c levels with
been since you last saw or talked to a dentist? Include all diabetic complications, thus allowing for a threshold
types of dentists, such as orthodontists, oral surgeons, and to be set above which patients would be diagnosed as
all other dental specialists as well as hygienists. Starting in having diabetes. Although the ADA recommends using
2001, the question was modified slightly to ask respondents hemoglobin A1c greater than or equal to 6.5% as an
422 Appendix II. Definitions and Methods Health, United States, 2016
indicator of undiagnosed diabetes, it cautions that A1c may as visits or hospitalizations; the first-listed diagnosis is often,
be misleading in individuals with certain blood disorders but not always, considered the most important or dominant
(including sickle cell trait), which may have specific ethnic condition among all comorbid conditions. However, the
or geographic distributions. Therefore, clinicians may use choice of the first-listed diagnosis by the medical facility may
other criteria and tests to diagnose a specific patient. For be influenced by reimbursement or other factors. (Also see
more information, see: Diagnosis and classification of Appendix II, External cause of injury; Injury; Injury-related
diabetes mellitus. Diabetes Care 2015;38(suppl 1):S8S16; visit.)
Standards of medical care in diabetes2010. Diabetes
Care 2010;33(suppl 1):S11S61; and International Expert Diagnostic and other nonsurgical procedureSee
Committee Report on the role of the A1c assay in the Appendix II, Procedure.
diagnosis of diabetes. Diabetes Care 2009;32(7):132734. To
ensure data comparability over time, the revised definition DischargeThe National Health Interview Survey defines
of undiagnosed diabetes was applied to all estimates shown a hospital discharge as the completion of any continuous
in Health, United States. As expected, this revised definition period of stay of one night or more in a hospital as an
increased the percentage of respondents classified as having inpatient. According to the Healthcare Cost and Utilization
undiagnosed diabetes. ProjectNational (Nationwide) Inpatient Sample, a
discharge is a completed inpatient hospitalization. A
Periodically, NHANES laboratory testing is performed at hospitalization may be completed by death or by release of
different laboratories and using different instruments than the patient to the customary place of residence, a nursing
testing in earlier years. In those instances, NHANES conducts home, another hospital, or other locations. (Also see
crossover studies to evaluate the impact of these changes Appendix II, Admission; Average length of stay; Days of care;
on laboratory measurements, and thus their impact on the Hospital utilization; Inpatient.)
evaluation of data over time. Crossover studies have been
conducted to evaluate the impact of laboratory changes on Domiciliary care homeSee Appendix II, Long-term care
both FPG and A1c. The recommended adjustments to FPG to facility; Nursing home.
account for laboratory changes from 20052006 to present
have been incorporated in estimates presented in Health, DrugDrugs are pharmaceutical agents, by any routes of
United States so that these estimates are compatible with administration, for the prevention, diagnosis, or treatment
those from earlier years. NHANES does not recommend any of medical conditions or diseases. Data on specific drug use
adjustments to the A1c data. are collected in several NCHS surveys. (Also see Appendix II,
Multum Lexicon Plus therapeutic class.)
Estimates presented in Health, United States may differ from
other estimates based on the same data and presented National Health and Nutrition Examination Survey
elsewhere if different weights, age-adjustment groups, (NHANES)Drug information from NHANES III and
definitions, or trend adjustments are used. from NHANES for 1999 and subsequent years was
collected during in-person interviews conducted
For more information, see: https://wwwn.cdc.gov/Nchs/ in participants homes. Starting with 2001 data,
Nhanes/2013-2014/GHB_H.htm and https://wwwn.cdc.gov/ participants were asked whether they had taken a
medication in the past 30 days for which they needed
Nchs/Nhanes/2013-2014/GLU_H.htm.
a prescription. For 19881994 and 19992014 data,
the question wording differed slightly; participants
DiagnosisDiagnosis is the act or process of identifying were asked whether they had taken a prescription
or determining the nature and cause of a disease or injury medication in the past month. For all survey years,
through evaluation of patient history, examination, and those who answered yes were asked to provide the
review of laboratory data. Diagnoses in the National prescription medication containers for the interviewer.
Ambulatory Medical Care Survey and the National Hospital For each medication reported, the interviewer entered
Ambulatory Medical Care Survey are abstracted from the products complete name from the container.
medical records and are currently coded to the International If no container was available, the interviewer asked
Classification of Diseases, 9th Revision, Clinical Modification the participant to verbally report the name of the
(ICD9CM). Starting with 2016 data, diagnosis data will medication. In addition, participants were asked how
be classified using International Classification of Diseases, long they had been taking the medication and the
10th Revision, Clinical Modification/Procedure Coding System main reason for use.
(ICD10CM/PCS).
All reported medication names were converted to
their standard generic ingredient name. For multi-
For a given medical care encounter, the first-listed diagnosis
ingredient products, the ingredients were listed in
can be used to categorize the visit, or if more than one alphabetical order and counted as one drug (e.g.,
diagnosis is recorded on the medical record, the visit can Tylenol #3 was listed as acetaminophen; codeine). No
be categorized based on all diagnoses recorded. Analyzing trade or proprietary names were provided on the data
first-listed diagnoses avoids double-counting events such file.
423 Appendix II. Definitions and Methods Health, United States, 2016
Drug data from NHANES provide a snapshot of all Data from the 1996 and 1997 NHIS were used to
prescribed drugs reported by a sample of the civilian compare distributions of educational attainment for
noninstitutionalized population for a 30-day period (or adults aged 25 and over, using categories based on
past month, for earlier survey years). Drugs taken on an educational credentials (1997) and categories based
irregular basis, such as every other day, once per week, on years of education completed (1996). A larger
or for a 10-day period, were captured in the 30-day percentage of persons reported some college than
recall period. Data shown in Health, United States for 1315 years of education, and a correspondingly
the percentage of the population reporting multiple smaller percentage reported a high school diploma
prescription drugs during the past 30 days include a or GED than 12 years of education. In 1997, 19% of
range of drug utilization patterns; for example, persons adults reported no high school diploma, 31% a high
who took three or more drugs daily during the past school diploma or GED, 26% some college, and 24%
30 days or persons who took a different drug three a bachelors degree or higher. In 1996, 18% of adults
separate times would be classified as taking three or reported less than 12 years of education, 37% reported
more drugs in the past 30 days, as long as at least three 12 years, 20% reported 1315 years, and 25% reported
drugs were taken at some time during the past 30 16 or more years of education.
days.
National Health and Nutrition Examination Survey
For more information on prescription drug data (NHANES)In 19881994 (NHANES III), the
collection and coding in NHANES, see: https://wwwn. questionnaire asked, What is the highest grade
cdc.gov/Nchs/Nhanes/2013-2014/RXQ_RX_H.htm and or year of regular school [person] has completed?
https://wwwn.cdc.gov/Nchs/Nhanes/1999-2000/ Responses were used to categorize adults according
RXQ_DRUG.htm. to educational credentials (i.e., no high school diploma
or GED; high school diploma or GED; some college,
For more information on NHANES III prescription drug no bachelors degree; bachelors degree or higher).
data collection and coding, see: ftp://ftp.cdc.gov/ Starting with 19992000 data, the questionnaire was
pub/Health_Statistics/NCHS/nhanes/nhanes3/2A/ changed to ask, What is the highest grade or level
pupremed.pdf. The small number of respondents of school [you have/(person) has] completed or the
(fewer than 10) who responded unknown to whether highest degree [you have/(person) has] received? For
they were taking prescription medication were coded data on children, education is based on the level of
as not taking prescription drugs in the past month. education completed by the head of the household.
(Also see Appendix I, National Health and Nutrition The question asked is, What is the highest grade or
Examination Survey [NHANES].) level of school [you have/(person) has] completed or
the highest degree [you have/(person) has] received?
Drug abuseSee Appendix II, Illicit drug use.
Emergency departmentAccording to the National
EducationSeveral approaches to defining educational Hospital Ambulatory Medical Care Survey, an emergency
categories are used in Health, United States. Estimates are department is a hospital facility that is staffed 24 hours a day
typically presented for adults aged 25 and over in order to and provides unscheduled outpatient services to patients
give people time to complete their education. whose condition requires immediate care. Emergency
services provided under the hospital as landlord
National Health Interview Survey (NHIS)Starting arrangement were also eligible. An emergency department
in 1997, the NHIS questionnaire was changed to was in scope if it was staffed 24 hours a day. If an in-scope
ask, What is the highest level of school [person] emergency department had an emergency service area
has completed or the highest degree received? that was open less than 24 hours a day, then that area was
Responses were used to categorize adults according included under the emergency department. If a hospital
to educational credentials (i.e., no high school diploma had an emergency department that was staffed less than 24
or general educational development high school hours a day, that department was considered an outpatient
equivalency diploma [GED]; high school diploma or clinic. (Also see Appendix II, Emergency department or
GED; some college, no bachelors degree; bachelors emergency room visit; Outpatient department.)
degree or higher).
Emergency department or emergency room visit
Prior to 1997, the education variable in NHIS was Starting with the 1997 National Health Interview Survey,
measured by asking, What is the highest grade or year respondents to the Sample Adult questionnaire and the
of regular school [person] has ever attended? and Did Sample Child questionnaire (a knowledgeable adult, usually
[person] finish the grade/year? Responses were used a parent) were asked about the number of visits to hospital
to categorize adults according to years of education emergency rooms during the past 12 months, including
completed (i.e., less than 12, 12, 1315, or 16 years or visits that resulted in hospitalization. In the National Hospital
more). Ambulatory Medical Care Survey, an emergency department
424 Appendix II. Definitions and Methods Health, United States, 2016
visit is a direct personal exchange between a patient and Hyattsville, MD: NCHS; 2008. Available from: http://www.cdc.
either a physician or a health care provider working under gov/nchs/data/misc/injury2007.pdf.
the physicians supervision, for the purpose of seeking care
and receiving personal health services. (Also see Appendix II, Family incomeFor the National Health Interview Survey
Emergency department; Injury-related visit.) and the National Health and Nutrition Examination Survey,
all people within a household who are related by blood,
Employer costs for employee compensationEmployer marriage or cohabitation, or adoption constitute a family.
costs for employee compensation is a measure of the Each member of a family is classified according to the total
average cost per employee hour worked, to employers for income of the family. Unrelated individuals are classified
wages, salaries, and benefits. Wages and salaries are defined according to their own income.
as the hourly straight-time wage rate or, for workers not
paid on an hourly basis, straight-time earnings divided National Health Interview Survey (NHIS)Prior to
by the corresponding hours. Straight-time wage and 1997, family income was the total income received by
salary rates are total earnings before payroll deductions, members of a family (or by an unrelated individual)
excluding premium pay for work in addition to the regular in the 12 months before interview. Family income
work schedule (e.g., overtime, weekends, and holidays), included wages, salaries, rents from property, interest,
shift differentials, and nonproduction bonuses such as dividends, profits and fees from their own businesses,
discretionary holiday bonuses and lump-sum payments pensions, and help from relatives. Starting in 1997,
provided in lieu of wage increases. Production bonuses, NHIS collected family income data for the calendar
incentive earnings, commission payments, and cost-of year prior to interview (e.g., 2015 family income data
living adjustments are included in straight-time wage were based on calendar year 2014 information). The
19972006 instrument allowed the respondent to
and salary rates. Benefits included as compensation are
supply a specific dollar amount (up to $999,995). Any
paid leave (paid vacations, holidays, sick leave, and other
family income responses greater than $999,995 were
leave), supplemental pay (premium pay for overtime,
entered as $999,996. Respondents who did not know
weekends, or holidays), shift differentials, nonproduction or refused to give a dollar amount in response to this
bonuses, insurance benefits (life, health, and short- and question were asked if their total combined family
long-term disability), retirement and savings benefits income for the previous year was $20,000 or more,
(pension and other retirement plans and savings and or less than $20,000. If the respondent answered this
thrift plans), and legally-required benefits (Social Security, question, he or she was then given one of two flash
Medicare, federal and state unemployment insurance, and cards and asked to indicate which income group listed
workers compensation). (Also see Appendix I, National on the card best represented the familys combined
Compensation Survey [NCS].) income during the previous calendar year. One flash
card listed incomes that were $20,000 or more, and
EthnicitySee Appendix II, Hispanic origin. the other flash card listed incomes that were less than
$20,000. Starting with the 2007 NHIS, the income
ExerciseSee Appendix II, Physical activity, leisure-time. amount follow-up questions that had been in place
since 1997 were replaced with a series of unfolding
ExpendituresSee Appendix II, Health expenditures, bracket questions. The unfolding bracket method
national. (Also see Appendix I, National Health Expenditure asked a series of closed-ended income range questions
Accounts [NHEA].) (e.g., Is it less than $50,000?) if the respondent
did not provide an answer to the exact income
External cause of injuryThe external cause of injury amount question. The closed-ended income range
is used for classifying the circumstances in which injuries questions were constructed so that each successive
occur. The International Classification of Diseases, 9th Revision question established a smaller range for the amount
(ICD9), External Cause of Injury Matrix, is a two-dimensional of the familys income. In 2011, 2012, and 2014, the
unfolding-bracket income questions were further
array describing both the mechanism or external cause of
refined to improve the assignment of poverty status.
the injury (e.g., fall, motor-vehicle traffic) and the manner
For more information on this series of family income
or intent of the injury (e.g., unintentional, self-inflicted, or
questions, see: 2015 NHIS public-use data release.
assault). Although this matrix was originally developed NCHS. 2016. Available from: http://www.cdc.gov/nchs/
for mortality, it has been adapted for use with the ICD9 nhis/nhis_2015_data_release.htm.
Clinical Modification (ICD9CM) and will be used in Health,
United States until 2016 data are available. Data for 2016 and Also see: Pleis JR, Cohen RA. Impact of income
beyond will be classified using the International Classification bracketing on poverty measures used in the National
of Diseases, 10th Revision, Clinical Modification/Procedure Health Interview Surveys Early Release Program:
Coding System (ICD10CM/PCS). For more information, Preliminary data from the 2007 NHIS. Hyattsville, MD:
see the NCHS website at: http://www.cdc.gov/nchs/injury/ NCHS. 2007. Available from: http://www.cdc.gov/nchs/
injury_tools.htm; and see: Bergen G, Chen LH, Warner M, data/nhis/income.pdf.
Fingerhut LA. Injury in the United States: 2007 chartbook.
425 Appendix II. Definitions and Methods Health, United States, 2016
For NHIS respondents, family income data are used onward and collected income received by all family
in the computation of a poverty measure. Starting members for the calendar year prior to the interview
with Health, United States, 2004, a new methodology year for households with age-eligible children (e.g.,
for imputing family income data for NHIS was 2015 NIS family income data are based on calendar
implemented for data years 1997 and beyond. Multiple year 2014 income). Family income is the combined
imputations were performed for survey years 1997 total income received by all members of a family
and beyond, with five sets of imputed values created before taxes. For the family income questions, the
to allow for the assessment of variability caused by household respondent is asked to include income
imputation. A detailed description of the multiple received from jobs, Social Security, retirement income,
imputation procedure, and data files for 1997 and unemployment payments, public assistance, interest,
beyond, are available from: http://www.cdc.gov/ dividends, net income from business, farm, rent, or
nchs/nhis/quest_data_related_1997_forward.htm any other sources. Respondents who answered dont
through the Data Release or the Imputed Income Files know or refused to give a dollar amount for the total
link under that year. For data years 19901996, about family income were asked a cascading sequence
16%18% of persons had missing data for family of income questionsa total of 15 cascading
income. In those years, missing values were imputed questionsthat attempt to place the family income
for family income by using a sequential hot deck into one of 15 income intervals ranging from less than
within matrix cells imputation approach. A detailed or equal to $7,500 to greater than or equal to $75,000.
description of the imputation procedure and data files, The initial question asks if the family income for the
with imputed annual family income for 19901996, is prior year was more or less than $20,000. Subsequent
available from: ftp://ftp.cdc.gov/pub/Health_Statistics/ sets of income range questions are asked so that each
NCHS/Datasets/NHIS/1990-96_Family_Income/. (Also successive question establishes a narrower income
see Appendix II, Poverty; Table VI.) range.
National Health and Nutrition Examination Survey A family income variable is constructed from the total
(NHANES)In NHANES 1999 and onward, family family income question and the cascading income
income is asked in a series of questions about questions. If an exact income is given, family income is
possible sources of income, including wages, salaries, set to this amount; otherwise it is set to the midpoint
interest and dividends, federal programs, child of the tightest bounds established by the cascading
support, rents, royalties, and other possible sources. income questions. The values of total family income
After the information about sources of income was are used to calculate an income-to-poverty ratio. For
obtained in the family interview income section of the NIS, this ratio is calculated only for households with
questionnaire, the respondent was asked to report age-eligible children, using either the actual family
total combined family income for him- or herself and income value or the midpoint of the interval from the
the other members of their family, in dollars. If the series of cascading questions in the numerator and
respondent did not provide an answer or did not the poverty threshold provided by the Census Bureau
know the total combined family income, he or she was for the size of the family and the number of related
asked if the total family income was less than $20,000 children in the household in the denominator. Details
or $20,000 or more. If the respondent answered, a of the income questions and computation of the
follow-up question asked the respondent to select income-to-poverty ratio for each data collection year
an income range from a list on a printed flash card. can be found in the NIS data documentation (Data
The midpoint of the income range was then used as Users Guide and Household Interview Questionnaire)
the total family income value. Family income values provided on the NIS website at: http://www.cdc.gov/
are used to calculate a poverty measure. NHANES vaccines/imz-managers/nis/data-tables.html.
II (19761980) included questions on components
of income; NHANES III (19881994) did not ask the For more information, see: Battaglia MP, Hoaglin
detailed components-of-income questions but asked DC, Izrael D, Khare M, Mokdad A. Improving income
respondents to identify their income based on a set of imputation by using partial income information
ranges provided on a flash card. Family income was not and ecological variables. Presented at the American
imputed for individuals or families with no reported Statistical AssociationJoint Statistical Meeting; 2002
income information in any of the NHANES survey years. Aug 1115, New York, NY. Available from: http://
(Also see Appendix II, Poverty.) www.cdc.gov/nchs/data/nis/estimation_weighting/
Battaglia2002.pdf.
National Immunization Survey (NIS)Prior to 1998,
family income was the total income received by all Federal hospitalSee Appendix II, Hospital.
family members in the past 12 months at the time of
interview. Following the changes in the NHIS income Fee-for-service health insuranceFee-for-service health
questions, NIS changed the reference period for 1998 insurance is private (commercial) health insurance that
426 Appendix II. Definitions and Methods Health, United States, 2016
reimburses health care providers on the basis of a fee for total health care contacts. Starting with 2000 data, response
each health service provided to the insured person. In categories were expanded to 0, 1, 23, 45, 67, 89, 1012,
addition, fee-for-service is a term often applied to original 1315, or 16 or more. For 2000 and more recent data, these
Medicare, to distinguish it from Medicare managed-care response categories were recoded to the midpoint of the
plans and other new payment systems. (Also see Appendix range. The category of 16 or more was recoded to 16. The
II, Health insurance coverage; Managed care; Medicare.) recoded values for the three types of visits were then added
to yield an estimate of the summary measure of health care
Fertility rateSee Appendix II, Rate: Birth and related rates. contacts (including doctors visits, hospital emergency room
visits, and home visits). After summing the three component
General hospitalSee Appendix II, Hospital. visit variables, respondents with values on the edge of the
categories presented in Health, United States were rounded
Geographic regionThe U.S. Census Bureau groups the 50 down to provide a more conservative estimate of the
states and D.C., for statistical purposes, into four geographic number of visits. For example, a respondent with 3.5 health
regions (Northeast, Midwest, South, and West) and nine care contacts was included in the 13 visits category, and
divisions based on geographic proximity. (See Figure I.) a respondent with 9.5 health care contacts was included in
the 49 visits category. Respondents were included in this
GestationFor the National Vital Statistics System and analysis only if they were known on all three visit variables.
CDCs Abortion Surveillance System, the period of gestation
is defined as beginning with the first day of the last normal Analyses of the percentage of children without a health care
menstrual period and ending with the day of birth or day visit are based on the following question: During the past
of termination of pregnancy. Data on gestational age are 12 months, how many times has [person] seen a doctor or
subject to error for several reasons, including imperfect other health care professional about [his/her] health at a
maternal recall or misidentification of the last menstrual doctors office, a clinic, or some other place? Do not include
period because of postconception bleeding, delayed times [person] was hospitalized overnight, visits to hospital
ovulation, or intervening early miscarriage. emergency rooms, home visits, or telephone calls. Starting
with 2000 data, this question was amended to specifically
Gross domestic product (GDP)The GDP is the market exclude dental visits. (Also see Appendix II, Emergency
value of the goods and services produced by labor and department or emergency room visit; Home visit.)
property located in the United States. As long as the labor
and property are located in the United States, the suppliers Health expenditures, nationalNational health
(i.e., the workers and, for property, the owners) may be U.S. expenditures are estimated by the Centers for Medicare
residents or residents of other countries. (Also see Appendix & Medicaid Services (CMS) and measure calendar year
II, Consumer Price Index [CPI]; Health expenditures, spending for health care in the United States by type of
national.) service delivered (e.g., hospital care, physician services,
nursing home care) and source of funding for those services
Health care contactStarting in 1997, the National Health (e.g., private health insurance, Medicare, Medicaid, out-
Interview Survey has collected information on health care of-pocket spending). CMS produces both historical and
contacts with doctors and other health care professionals projected estimates of health expenditures by category.
by using the following series of questions: During the past (Also see Appendix I, National Health Expenditure Accounts
12 months, how many times have you gone to a hospital [NHEA]; Appendix II, Gross domestic product [GDP].) Types of
emergency room about your own health?, During the past national health expenditures include:
12 months, did you receive care at home from a nurse or
other health care professional? What was the total number Health consumption expenditures are outlays for
of home visits received?, and During the past 12 months, goods and services relating directly to patient care,
how many times have you seen a doctor or other health care plus expenses for administering health insurance
professional about your own health at a doctors office, a programs, the net cost of health insurance, and public
clinic, or some other place? Do not include times you were health activities. This category is equivalent to total
hospitalized overnight, visits to hospital emergency rooms, national health expenditures minus expenditures for
home visits, or telephone calls. Starting with 2000 data, this investment in noncommercial research and structures
question was amended to specifically exclude dental visits. and equipment.
For 19971999, for each question, respondents were shown Personal health care expenditures are outlays for goods
a flash card with response categories of 0, 1, 23, 49, 1012, and services relating directly to patient care. These
or 13 or more visits. For tabulation of the 19971999 data, expenditures are total national health expenditures
responses of 23 were recoded to 2, responses of 49 were minus expenditures for investment, health insurance
recoded to 6, responses of 1012 were recoded to 11, and 13 program administration and the net cost of insurance,
or more visits were recoded to 13. The recoded values for the and public health activities.
three types of visits were then added to yield an estimate of
427 Appendix II. Definitions and Methods Health, United States, 2016
Table VI. Imputed family income percentages in the National Health Interview Survey, by selected characteristics:
United States, 19902015
Females Females
All Under 18 years 18-64 Under 1-64 65 years 18 years 40 years 2 years 45 years
Year ages 18 years and over years 65 years years and over and over and over and over and over
Percent
1990 . . . . . . . . . . . 16 14 18 16 15 15 24 18 21 17 22
1991 . . . . . . . . . . . 18 15 19 17 17 17 26 19 23 18 23
1992 . . . . . . . . . . . 18 16 19 18 17 17 27 20 23 18 23
1993 . . . . . . . . . . . 16 14 17 16 15 15 23 17 19 16 20
1994 . . . . . . . . . . . 17 15 18 17 16 16 25 18 21 17 21
1995 . . . . . . . . . . . 16 14 16 15 15 15 22 17 19 16 19
1996 . . . . . . . . . . . 17 14 17 16 16 16 24 18 20 17 20
1997 . . . . . . . . . . . 24 21 26 24 23 23 34 26 30 25 30
1998 . . . . . . . . . . . 29 25 30 28 27 27 39 30 34 29 34
1999 . . . . . . . . . . . 31 27 32 30 29 29 43 33 37 31 37
2000 . . . . . . . . . . . 32 28 33 31 30 31 45 34 38 32 38
2001 . . . . . . . . . . . 32 27 33 31 30 30 44 34 37 32 38
2002 . . . . . . . . . . . 32 28 33 31 30 30 44 33 37 32 37
2003 . . . . . . . . . . . 33 30 35 33 32 32 44 35 38 34 38
2004 . . . . . . . . . . . 33 29 34 32 31 31 41 34 36 33 37
2005 . . . . . . . . . . . 33 29 34 32 31 31 44 35 37 33 38
2006 . . . . . . . . . . . 34 31 35 33 33 33 45 36 39 34 39
2007 . . . . . . . . . . . 33 29 34 32 31 31 43 35 38 33 37
2008 . . . . . . . . . . . 30 27 31 29 29 29 40 32 34 30 34
2009 . . . . . . . . . . . 25 21 26 24 23 23 34 26 29 25 29
2010 . . . . . . . . . . . 25 20 26 24 23 23 36 27 30 25 30
2011 . . . . . . . . . . . 22 19 23 22 21 21 31 24 26 23 26
2012 . . . . . . . . . . . 23 19 24 22 21 21 32 24 27 23 27
2013 . . . . . . . . . . . 23 19 24 23 22 22 31 25 27 23 27
2014 . . . . . . . . . . . 23 20 24 23 22 22 31 25 27 23 27
2015 . . . . . . . . . . . 23 20 24 22 22 22 31 24 26 23 26
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Business, household, and other private expenditures American Community Survey (ACS)For point-in-time
are outlays for services paid for by nongovernmental health insurance estimates, ACS respondents were
sources, such as consumers, private industry, and asked about their coverage at the time of interview.
philanthropic and other non-patient-care sources. Respondents were asked: Is this person CURRENTLY
covered by any of the following types of health
Government expenditures are outlays for services paid insurance or health coverage plans? Mark yes or no for
for by federal, state, and local government agencies each type of coverage: Insurance through a current or
or expenditures required by governmental mandate former employer or union [of this person or another
(such as workers compensation insurance payments). family member]; Insurance purchased directly from
an insurance company [by this person or another
Health insurance coverageHealth insurance is broadly family member]; Medicare, for people 65 and older,
defined to include both public and private payers who cover or people with certain disabilities; Medicaid, Medical
medical expenditures incurred by a defined population Assistance, or any kind of government-assistance
in a variety of settings. Estimates of health insurance are plan for those with low incomes or a disability;
available from several different government surveys. TRICARE or other military health care; VA (including
Because of differences in methodology, question wording, those who have ever used or enrolled for VA health
and recall period, estimates from different sources may vary care); Indian Health Service; Any other type of health
and are not directly comparable. For more information, see: insurance or health coverage plan [specify plan]. In
Health insurance measurement and estimates. Available ACS, persons were considered uninsured if they were
from: https://www.census.gov/content/dam/Census/library/ not covered by private health insurance, Medicare,
working-papers/2015/demo/2015-Vornovitsy-Day-01.pdf Medicaid, Medical Assistance, TRICARE or other military
health care, veterans coverage through the Veterans
Administration, or other government coverage.
428 Appendix II. Definitions and Methods Health, United States, 2016
Figure I. U.S. Census Bureau: Four geographic regions and nine divisions of the United States
West Northeast
WA Midwest ME
New
MT ND England
OR MN
WI NY
ID SD
MI Middle
WY
West North Atlantic RI
Pacific Central East North
NJ
IA Central
Mountain NE OH
NV IN DE
UT MD
CO WV
CA VA
KS DC
MO
KY
South
OK East Atlantic
AZ
NM A
AR South
West South Central
GA
Central AL
TX LA
FL
AK
South
HI
People with Indian Health Service coverage only were obtained through a present or former employer or
considered uninsured in ACS. union or, starting in 1997, through the workplace, self-
employment, or a professional association. Starting
National Health Interview Survey (NHIS)For point-in in 2011, respondents were also asked whether health
time health insurance estimates, NHIS respondents insurance coverage was obtained through parents
were asked about their coverage at the time of or another relative. Starting in 2014, an additional
interview. For 19931996, respondents were asked question on the health insurance marketplace was
about their coverage in the previous month. Questions added to the questionnaire for those respondents who
on health insurance coverage were expanded starting did not indicate that their health plan was obtained
in 1993, compared with previous years. In 1997, the through a present or former employer, union, self-
entire questionnaire was redesigned and data were employment, or professional association. Starting in
collected using a computer-assisted personal interview 2015, an additional answer category was added to the
(CAPI). In 2007, questions on health insurance question on how a health plan was originally obtained
coverage were expanded again to include three new to allow a respondent to indicate that their plan was
questions on high-deductible health plans, health obtained through the Health Insurance Marketplace or
savings accounts, and flexible spending accounts. state-based exchange.
Respondents were considered to be covered by private Until 1996, persons were defined as having Medicaid
health insurance if they indicated private health or other public assistance coverage if they indicated
insurance or, prior to 1997, if they were covered by a that they had either Medicaid or other public
single-service hospital plan. Private health insurance assistance or if they reported receiving Aid to Families
includes managed care such as health maintenance with Dependent Children (AFDC) or Supplemental
organizations (HMOs). Security Income (SSI). After welfare reform in late
1996, Medicaid was delinked from AFDC and SSI.
Private insurance obtained through the workplace was Starting in 1997, persons were considered to be
defined as any private insurance that was originally covered by Medicaid if they reported Medicaid or a
429 Appendix II. Definitions and Methods Health, United States, 2016
state-sponsored health program. Starting in 1999, who were eligible to receive the Medicare probe
persons also were considered covered by Medicaid question in the third and fourth quarters of 2004, 55%
if they reported coverage by the Childrens Health indicated that they were covered by Medicare. Of
Insurance Program (CHIP). Medicare or military health the 9,146 people (unweighted) who were eligible to
plan coverage was also determined in the interview receive the Medicaid probe question in the third and
and, starting in 1997, other government-sponsored fourth quarters of 2004, 3% indicated that they were
program coverage was determined as well. covered by Medicaid. From 2004 onwards, estimates
in Health, United States were calculated using the
If respondents did not report coverage under one responses to the two additional probe questions. For
of the above types of plans and they had unknown a complete discussion of the effect of the addition
coverage under either private health insurance or of these two probe questions on the estimates for
Medicaid, they were considered to have unknown insurance coverage, see: Cohen RA, Martinez ME.
coverage. Impact of Medicare and Medicaid probe questions on
health insurance estimates from the National Health
The remaining respondents without any indicated Interview Survey, 2004. Health E-Stats. NCHS; 2005.
coverage were considered uninsured. The uninsured Available from: http://www.cdc.gov/nchs/data/hestat/
were persons who did not have coverage under impact04/impact04.htm.
private health insurance, Medicare, Medicaid, public
assistance, a state-sponsored health plan, other Survey respondents may be covered by health
government-sponsored programs, or a military health insurance at the time of interview but may have
plan. Persons with only Indian Health Service (IHS) experienced one or more lapses in coverage during
coverage were considered uninsured. Although NHIS the 12 months prior to interview. Starting with
respondents who report IHS coverage as their only Health, United States, 2006, NHIS estimates have
source of coverage are currently recoded to being been presented for the following three exhaustive
uninsured, IHS provides a comprehensive health categories: (a) people with health insurance
service delivery system for approximately 2.2 million continuously for the full 12 months prior to interview,
American Indian or Alaska Native persons. See: https:// (b) those who had a period of up to 12 months prior
www.ihs.gov/newsroom/factsheets/ihsprofile/. to interview without coverage, and (c) those who were
Estimates of the percentage of persons who were uninsured for more than 12 months prior to interview.
uninsured based on NHIS may differ slightly from This stub variable has been added to selected tables.
those based on other sources because of differences Two additional NHIS questions were used to determine
in survey questions, recall period, and other aspects of the appropriate category for the survey respondents:
survey methodology. (a) all persons without a known comprehensive health
insurance plan were asked, About how long has it
In NHIS, on average less than 2% of people aged been since [person] last had health care coverage?;
65 and over reported no current health insurance and (b) all persons with known health insurance
coverage, but the small sample size precludes the coverage were asked, In the past 12 months, was there
presentation of separate estimates for this population. any time when [person] did NOT have ANY health
Therefore, the term uninsured refers only to the insurance coverage?
population under age 65.
(Also see Appendix II, Childrens Health Insurance Program
Two additional questions were added to the health [CHIP]; Fee-for-service health insurance; Health maintenance
insurance section of NHIS beginning with the third organization [HMO]; Managed care; Medicaid; Medicare;
quarter of 2004 (Table VII). One question was asked Uninsured.)
of persons aged 65 and over who had not indicated
that they had Medicare: People covered by Medicare Health maintenance organization (HMO)An HMO is a
have a card which looks like this. [Are/Is] [person] health care system that assumes or shares both the financial
covered by Medicare?The other question was asked risks and the delivery risks associated with providing
of persons under age 65 who had not indicated comprehensive medical services to a voluntarily enrolled
any type of coverage: There is a program called population in a particular geographic area, usually in return
Medicaid that pays for health care for persons in for a fixed, prepaid fee. Pure HMO enrollees use only the
need. In this state it is also called [state name]. [Are/ prepaid, capitated health services of the HMO panel of
Is] [person] covered by Medicaid? Respondents who medical care providers. Open-ended HMO enrollees use the
originally classified themselves as uninsured, but prepaid HMO health services but may also receive medical
whose classification was changed to Medicare or care from providers who are not part of the HMO panel.
Medicaid on the basis of a yes response to either There is usually a substantial deductible, copayment, or
question, subsequently received appropriate follow- coinsurance associated with use of nonpanel providers.
up questions concerning periods of noncoverage for HMO model types are as follows:
insured respondents. Of the 892 people (unweighted)
430 Appendix II. Definitions and Methods Health, United States, 2016
Group model HMO is an HMO that contracts with a [do you have] a little trouble hearing, moderate trouble, a
single multispecialty medical group to provide care to lot of trouble, or are you deaf? Because of the expanded
the HMOs membership. The group practice may work response categories, 2007 and subsequent data are not
exclusively with the HMO, or it may provide services to strictly comparable with earlier years and caution is urged
non-HMO patients as well. The HMO pays the medical when interpreting trends. For example, in 2006, 3.5% of
group a negotiated per capita rate, which the group adults (aged 18 and over) were classified as having hearing
distributes among its physicians, usually on a salaried difficulty (response categories: a lot of trouble or deaf ).
basis. In 2007, 2.3% of adults (aged 18 and over) were classified
as having hearing difficulty (response categories: a lot of
Staff model HMO is a closed-panel HMO (where trouble or deaf ). This more than 30% decline from 2006
patients can receive services only through a limited to 2007 in the estimate of those with hearing trouble is
number of providers) in which physicians are HMO likely attributable to the addition of the moderate trouble
employees. The providers see members in the HMOs response category, rather than changes in the prevalence
own facilities. of hearing trouble. Although all age groups saw a decline
in the percentage reporting hearing trouble between 2006
Network model HMO is an HMO that contracts with and 2007, the amount of the decline varied. There was a
multiple physician groups to provide services to HMO 50% decline in reported hearing trouble among adults aged
members. It may include single or multispecialty 1844 (from 0.8% in 2006 to 0.4% in 2007). Among adults
groups. aged 4564, the percentage that reported hearing trouble
declined 43%, from 3.5% in 2006 to 2.0% in 2007. Among
Individual practice association (IPA) is a health care adults aged 65 and over, reported hearing trouble declined
provider organization composed of a group of 24%, from 11.4% in 2006 to 8.7% in 2007.
independent practicing physicians who maintain their
own offices and band together for the purpose of For more information, see: Pleis JR, Lucas JW. Summary
contracting their services to HMOs, preferred provider health statistics for U.S. adults: National Health Interview
organizations, and insurance companies. An IPA may Survey, 2007. NCHS. Vital Health Stat 2009;10(240). Available
contract with and provide services to both HMO and from: http://www.cdc.gov/nchs/data/series/sr_10/sr10_240.
non-HMO plan participants. pdf. (Also see Appendix II, Basic actions difficulty.)
Mixed model HMO is an HMO that combines features of Hispanic originHispanic or Latino origin includes
more than one HMO model. persons of Mexican, Puerto Rican, Cuban, Central and South
American, and other or unknown Latin American or Spanish
(Also see Appendix II, Managed care; Preferred provider origin. Persons of Hispanic origin may be of any race.
organization [PPO].)
Birth fileThe reporting area for an Hispanic-origin
Health services and supplies expendituresSee item on the birth certificate expanded between 1980
Appendix II, Health expenditures, national. and 1993 (when the Hispanic item was included on
the birth certificate in all states and D.C.). Trend data
Health status, respondent-assessedHealth status was on births of Hispanic and non-Hispanic parentage
measured in the National Health Interview Survey by asking in Health, United States are affected by expansion of
the family respondent about his or her health or the health the reporting areas, which affects numbers of events,
of a family member: Would you say [persons] health in composition of the Hispanic population, and maternal
general is excellent, very good, good, fair, or poor? and infant health characteristics.
Hearing troubleIn the National Health Interview Survey, In 1980 and 1981, information on births of Hispanic
information about hearing trouble is obtained by asking parentage was reported on the birth certificate by
respondents how well they hear without the use of hearing the following 22 states: Arizona, Arkansas, California,
aids. Prior to 2007 data, respondents were asked, Which Colorado, Florida, Georgia, Hawaii, Illinois, Indiana,
statement best describes your hearing without a hearing aid: Kansas, Maine, Mississippi, Nebraska, Nevada, New
good, a little trouble, a lot of trouble, or deaf? Starting with Jersey, New Mexico, New York, North Dakota, Ohio,
2007 data, the question was revised to expand the response Texas, Utah, and Wyoming. In 1982 Tennessee, and in
categories. Respondents were asked, These next questions 1983 D.C., began reporting this information. Between
are about your hearing WITHOUT the use of hearing aids 1983 and 1987, information on births of Hispanic
or other listening devices. Is your hearing excellent, good, parentage was available for 23 states and D.C. In
[do you have] a little trouble hearing, moderate trouble, 1988, this information became available for Alabama,
a lot of trouble, or are you deaf? Starting with 2008 data, Connecticut, Kentucky, Massachusetts, Montana,
respondents were asked, WITHOUT the use of hearing aids North Carolina, and Washington state, increasing the
or other listening devices, is your hearing excellent, good, number of states reporting information on births of
431 Appendix II. Definitions and Methods Health, United States, 2016
Table VII. Percentage of persons under age 65 with Medicaid or who are uninsured, by selected demographic
characteristics, using Method 1 and Method 2 estimation procedures: United States, 2004
Medicaid 1 Uninsured 2
Characteristic Method 2 3 Method 1 3 Method 2 3 Method 1 3
1
Includes persons who do not have private coverage but who have Medicaid or other state-sponsored health plans, including the Childrens Health Insurance Program
(CHIP).
2
Includes persons who have not indicated that they are covered at the time of interview under private health insurance, Medicare, Medicaid, CHIP, a state-sponsored
health plan, other government programs, or military health plan (includes VA, TRICARE, and CHAMP-VA). This category includes persons who are only covered by
Indian Health Service (IHS) or only have a plan that pays for one type of service, such as accidents or dental care.
3
Starting with the third quarter of 2004, two additional questions were added to the National Health Interview Survey (NHIS) insurance section to reduce potential errors
in reporting of Medicare and Medicaid status. Persons aged 65 and over not reporting Medicare coverage were asked explicitly about Medicare coverage, and persons
under age 65 with no reported coverage were asked explicitly about Medicaid coverage. Estimates calculated without using the additional information from these
questions are noted as Method 1. Estimates calculated using the additional information from these questions are noted as Method 2.
4
Based on family income and family size and composition, using the U.S. Census Bureaus poverty thresholds. The percentage of respondents with unknown poverty
level was 28.2% in 2004. See the NHIS Survey Description for 2004. Available from: http://www.cdc.gov/nchs/data/nhis/srvydesc.pdf.
5
Persons of Hispanic origin may be of any race or combination of races. Similarly, the category Not Hispanic or Latino refers to all persons who are not of Hispanic or
Latino origin, regardless of race.
SOURCE: NCHS, National Health Interview Survey, 2004. Family Core Component. Data are based on household interviews of a sample of the civilian
noninstitutionalized population. Available from: http://www.cdc.gov/nchs/data/hestat/impact04/impact04.htm. See Appendix I, National Health Interview Survey (NHIS).
432 Appendix II. Definitions and Methods Health, United States, 2016
Hispanic parentage to 30 states and D.C. In 1989, this observation. See Appendix II, Hispanic origin; sections
information became available from an additional 17 for Birth file, Mortality file.
states, increasing the number of Hispanic-reporting
states to 47 and D.C. In 1989, only Louisiana, New Mortality fileThe reporting area for an Hispanic-origin
Hampshire, and Oklahoma did not report Hispanic item on the death certificate expanded between 1985
parentage on the birth certificate. With the inclusion of and 1997. In 1985, mortality data by Hispanic origin
Louisiana in 1989 and Oklahoma in 1990 as Hispanic- of decedent were based on deaths of residents of the
reporting states, 99% of birth records included following 17 states and D.C. whose data on the death
information on mothers origin. Hispanic origin of the certificate were at least 90% complete on a place-of
mother was reported on the birth certificates of 49 occurrence basis and of comparable format: Arizona,
states and D.C. in 1991 and 1992; only New Hampshire Arkansas, California, Colorado, Georgia, Hawaii, Illinois,
did not provide this information. Starting in 1993, Indiana, Kansas, Mississippi, Nebraska, New York,
Hispanic origin of mother was reported by all 50 states North Dakota, Ohio, Texas, Utah, and Wyoming. In
and D.C. 1986, New Jersey began reporting Hispanic origin of
decedent, increasing the number of reporting states
Starting with 2003 data, some states began using the to 18 and D.C. in 1986 and 1987. In 1988, Alabama,
2003 revision of the U.S. Standard Certificate of Live Kentucky, Maine, Montana, North Carolina, Oregon,
Birth. Hispanic origin and race are collected separately Rhode Island, and Washington state were added to the
on the birth certificate. The Hispanic origin question reporting area, increasing the number of states to 26
on the 2003 revision of the birth certificate asks and D.C. In 1989, an additional 18 states were added,
respondents to select only one response. Occasionally, increasing the Hispanic reporting area to 44 states
more than one Hispanic origin response is given; that and D.C.; only Connecticut, Louisiana, Maryland, New
is, a specified Hispanic origin group (Mexican, Puerto Hampshire, Oklahoma, and Virginia were not included
Rican, Cuban, or Central and South American) in in the reporting area. Starting with 1990 data in Health,
combination with one or more other specified Hispanic United States, the criterion was changed to include
origin groups. From 2003 through 2012, respondents states whose data were at least 80% complete. In 1990,
who selected more than one Hispanic origin on the Maryland, Virginia, and Connecticut; in 1991 Louisiana;
birth certificate were classified as other Hispanic. In and in 1993 New Hampshire were added, increasing
2012, 0.4% of births in the revised-state reporting area, the reporting area for Hispanic origin of decedent to
plus Massachusetts (unrevised state that also reported 47 states and D.C. in 1990; 48 states and D.C. in 1991
more than one Hispanic origin response), were to and 1992; and 49 states and D.C. in 19931996. Only
women reporting more than one Hispanic origin. Oklahoma did not provide this information in
Beginning with 2013 data, respondents who select 19931996. Starting in 1997, Hispanic origin of
more than one Hispanic origin are randomly assigned decedent was reported by all 50 states and D.C.
to a single Hispanic origin. The Hispanic origin Based on data from the U.S. Census Bureau, the
question on the 1989 revision of the birth certificate 1990 reporting area encompassed 99.6% of the U.S.
also offers the opportunity to report more than one Hispanic population. In 1990, more than 96% of death
origin; however, NCHS processing guidelines for records included information on Hispanic origin of the
unrevised data allow for coding only the first Hispanic decedent.
origin listed.
Starting with 2003 data, some states began using the
Linked birth/Infant death fileThe linked birth/ 2003 revision of the U.S. Standard Certificate of Death,
infant death file is particularly useful for computing which allows the reporting of more than one race
accurate infant mortality rates by race and Hispanic (multiple races) and includes some revisions in the
origin because the race and Hispanic origin of the item reporting Hispanic origin. The effect of the 2003
mother from the birth certificate are used in both the revision of the Hispanic origin item on the reporting
numerator and denominator of the linked birth/infant of Hispanic origin on death certificates is presumed to
death infant mortality rate. In contrast, infant mortality be minor. For more information, see Appendix II, Race.
rates based on the vital statistics mortality file use for Also see the Technical Notes section of the annual
the numerator race and Hispanic origin as reported on series of Deaths: Final Data reports, available from:
the death certificate and for the denominator the race http://www.cdc.gov/nchs/products/nvsr.htm; and
and Hispanic origin of the mother as reported on the NCHS procedures for multiple-race and Hispanic origin
birth certificate. Race and Hispanic origin information data: Collection, coding, editing, and transmitting.
from the birth certificate, which is reported by the Hyattsville, MD: NCHS; 2004. Available from:
mother, is considered more reliable than race and http://www.cdc.gov/nchs/data/dvs/Multiple_race_
Hispanic origin information from the death certificate, docu_5-10-04.pdf.
which is reported by the funeral director based
on information provided by an informant or by
433 Appendix II. Definitions and Methods Health, United States, 2016
National Health Interview Survey (NHIS) and National about Hispanic origin (Are you Hispanic or Latino?)
Health and Nutrition Examination Survey (NHANES) and a second separate question about race that
Questions on Hispanic origin are self-reported in included the option of selecting one or more of the
NHANES III and subsequent years, and since 1976 in following categories: American Indian or Alaska Native,
NHIS, and precede questions on race. For 19992006 Asian, black or African American, Native Hawaiian
data, the NHANES sample was designed to provide or Other Pacific Islander, or white. Because of the
estimates specifically for persons of Mexican origin differences between questions, the data about race
and not for all Hispanic-origin persons in the United and Hispanic ethnicity for the years prior to 1999
States. Persons of Hispanic origin other than Mexican are not strictly comparable with estimates for the
were entered into the sample with different selection subsequent years. However, analyses of data collected
probabilities that are not nationally representative between 1991 and 2003 have indicated that the data
of the total U.S. Hispanic population. Starting with are comparable across years and can be used to study
20072008 data collection, all Hispanic persons were trends. See Appendix II, Race; and see: Brener ND, Kann
oversampled, not just persons of Mexican origin. In L, McManus T. A comparison of two survey questions
addition to allowing estimates for the total group on race and ethnicity among high school students.
of Hispanic persons, the sample size for Hispanic Public Opin Q 2003;67(2):22736.
persons of Mexican origin is sufficient to continue to
produce reliable estimates for this group. However, the HIVSee Appendix II, Human immunodeficiency virus (HIV)
methodology for the oversampling of Hispanic persons disease.
did not provide sufficient sample sizes for calculating
estimates for other Hispanic subgroups besides Home visitStarting in 1997, the National Health
Mexican origin. For more information on the NHANES Interview Survey has been collecting information on home
sampling methodology changes, see https://wwwn. visits received during the 12 months prior to interview.
cdc.gov/nchs/data/series/sr02_160.pdf; and the series Respondents are asked, During the past 12 months, did
of NHANES analytic guidelines available from: http:// you receive care at home from a nurse or other health care
www.cdc.gov/nchs/nhanes/survey_methods.htm. For professional? What was the total number of home visits
more information on race and Hispanic origin in NHIS, received?These data are combined with data on visits to
see the NHIS Race and Hispanic Origin Information doctors offices, clinics, and emergency departments to
home page. Available from: http://www.cdc.gov/nchs/ provide a summary measure of adult health care visits. (Also
nhis/rhoi.htm. see Appendix II, Emergency department or emergency room
visit; Health care contact.)
Surveillance, Epidemiology, and End Results (SEER)
ProgramSEER data are available from the National HospitalAccording to the American Hospital Association
Institutes of Health, National Cancer Institute. SEER (AHA), hospitals are licensed institutions with at least six
Hispanic data used in Health, United States tables beds whose primary function is to provide diagnostic and
exclude data from Alaska. The North American therapeutic patient services for medical conditions; they
Association of Central Cancer Registries, Inc. (NAACCR) have an organized physician staff and provide continuous
Hispanic Identification Algorithm was used on a nursing services under the supervision of registered
combination of variables to classify incidence cases nurses. The World Health Organization (WHO) considers an
as Hispanic for analytic purposes. See: NAACCR establishment to be a hospital if it is permanently staffed by
guideline for enhancing HispanicLatino identification. at least one physician, can offer inpatient accommodation,
Bethesda, MD: National Cancer Institute; 2003. and can provide active medical and nursing care. Hospitals
Available from: http://seer.cancer.gov/seerstat/ may be classified by type of service, ownership, size in
variables/seer/yr1973_2004/race_ethnicity/. terms of number of beds, and length of stay. In the National
Hospital Ambulatory Medical Care Survey, hospitals include
Youth Risk Behavior Survey (YRBS)Prior to 1999, a all those with an average length of stay for all patients of
single question was asked about race and Hispanic less than 30 days (short-stay) or hospitals whose specialty
origin, with the option of selecting one of the is general (medical or surgical) or childrens general. Federal
following categories: white not Hispanic, black not hospitals and hospital units of institutions and hospitals
Hispanic, Hispanic or Latino, Asian or Other Pacific with fewer than six beds staffed for patient use are excluded.
Islander, American Indian or Alaska Native, or other. (Also see Appendix II, Average length of stay; Bed, health
Between 1999 and 2003, respondents were asked facility; Days of care; Emergency department; Inpatient;
a single question about race and Hispanic origin Outpatient department.)
with the option of choosing one or more of the
following categories: white, black or African American, Community hospitalCommunity hospitals, based
Hispanic or Latino, Asian, Native Hawaiian or Other on the AHA definition, include all nonfederal, short-
Pacific Islander, or American Indian or Alaska Native. term general and special hospitals whose facilities and
Beginning in 2005, respondents were asked a question services are available to the public. Special hospitals
434 Appendix II. Definitions and Methods Health, United States, 2016
include obstetrics and gynecology; eye, ear, nose, and Hospital utilizationEstimates of hospital utilization
throat; rehabilitation; orthopedic; and other specialty (such as hospital discharge rate, days of care rate, average
services. Short-term general and special childrens length of stay, and percentage of the population with a
hospitals are also considered to be community hospitalization) presented in Health, United States are based
hospitals. A hospital may include a nursing-home-type on data from three sources: Healthcare Cost and Utilization
unit and still be classified as short-term, provided that Project, National (Nationwide) Inpatient Sample (HCUPNIS);
the majority of its patients are admitted to units where National Health Interview Survey (NHIS); and American
the average length of stay is less than 30 days. Hospital Hospital Association (AHA). Beginning with the 2012 data
units of institutions such as prisons and college year, HCUPNIS is a 20% sample of discharges (alive or
infirmaries that are not open to the public and are deceased) from all community hospitals participating in
contained within a nonhospital facility are not included HCUP, excluding rehabilitation and long-term acute care
in the category of community hospitals. Traditionally, hospitals. For prior years, HCUPNIS estimates are based
the definition has included all nonfederal short-stay on hospital stays for persons discharged alive or deceased
hospitals except facilities for persons with intellectual from about 1,000 hospitals sampled to approximate a 20%
disabilities (formerly called mentally retarded). In a stratified sample of U.S. community hospitals, excluding
revised definition, the following additional sites were rehabilitation hospitals and long-term acute care hospitals.
excluded: hospital units of institutions, and alcoholism NHIS hospital utilization data are based on household
and chemical dependency facilities. interviews with a sample of the civilian noninstitutionalized
population. NHIS respondents were asked whether they had
Federal hospitalFederal hospitals are those operated any hospital stays in the past year, excluding overnight stays
by the federal government. in the emergency room. AHA data are from information
reported by a census of hospitals. (Also see Appendix
For-profit hospitalFor-profit hospitals are operated II, Average length of stay; Days of care; Discharge; and
for profit by individuals, partnerships, or corporations. Appendix I, Healthcare Cost and Utilization Project [HCUP],
National [Nationwide] Inpatient Sample; National Health
General hospitalGeneral hospitals provide Interview Survey [NHIS].)
diagnostic, treatment, and surgical services for patients
with a variety of medical conditions. According to Human immunodeficiency virus (HIV) diseaseHIV
WHO, these hospitals provide medical and nursing disease is caused by infection with a cytopathic retrovirus,
care for more than one category of medical discipline which in turn leads to destruction of parts of the immune
(e.g., general medicine, specialized medicine, general system. A surveillance case for HIV requires laboratory-
surgery, specialized surgery, and obstetrics). Excluded confirmed evidence of infection, including a positive
are hospitals, usually in rural areas, that provide a more result on a screening test for HIV antibody, followed by a
limited range of care. positive result on a confirmatory test, or a positive result
or detectable quantity on an HIV virologic test (see, CDC.
Nonprofit hospitalNonprofit hospitals are those HIV Surveillance Report, 2015; vol. 27. 2016. Available from:
controlled by nonprofit organizations, such as religious http://www.cdc.gov/hiv/library/reports/hiv-surveillance.
organizations and fraternal societies. html).
Registered hospitalRegistered hospitals are those Since 1985, many states and U.S. dependent areas
registered with AHA. About 98% of U.S. hospitals are have implemented HIV case reporting as part of their
registered. comprehensive HIV and AIDS surveillance programs. As of
April 2008, all reporting areas (50 states, D.C., and the six U.S.
Short-stay hospitalIn the National Health Interview dependent areas of American Samoa, Guam, the Northern
Survey, short-stay hospitals are defined as any hospital Mariana Islands, Puerto Rico, the Republic of Palau, and the
or hospital department in which the type of service U.S. Virgin Islands) had implemented HIV case surveillance
provided is general; maternity; eye, ear, nose, and using a confidential system for name-based case reporting
throat; childrens; or osteopathic. for both HIV infection and AIDS. To better capture and
characterize populations in which HIV infection has been
Special hospitalSpecial hospitals are those, newly diagnosed, including persons with evidence of recent
such as psychiatric, tuberculosis, chronic disease, HIV infection, many states report the prevalence of those
rehabilitation, maternity, and alcoholic or narcotic living with a diagnosis of HIV infection, including those
dependency facilities, that provide a particular type of living with AIDS.
service to the majority of their patients.
In 2008, changes were made to the case definition for
Hospital-based physicianSee Appendix II, Physician. HIV infection. The new case definition combined the two
previous case definitions for HIV and AIDS and established
Hospital daySee Appendix II, Days of care. a new disease staging classification. The term HIV/AIDS was
435 Appendix II. Definitions and Methods Health, United States, 2016
replaced with the term diagnosis of HIV infection, which is HIV infection, stage unknown: No reported information
defined as diagnosis of HIV infection regardless of the stage on AIDS-defining conditions and no information
of disease (stage 1, 2, 3 [AIDS], or unknown) and refers to available on CD4 count or percentage.
all persons with a diagnosis of HIV infection (see MMWR
2008;57 [RR10]:18). Mortality codingStarting with 1999 data and the
introduction of the 10th revision of the International
In 2014, the HIV surveillance case definition was revised Classification of Diseases (ICD10), the title for this cause of
again to adapt to changes in diagnostic criteria used death was changed from HIV infection to HIV disease, and
by laboratories and clinicians. The new case definition the ICD codes were changed to B20B24. Starting with 1987
recognizes early HIV infection (stage 0); includes the data, NCHS introduced category numbers *042*044 for
distinction between HIV1 and HIV2 infections; classifying and coding HIV infection as a cause of death in
consolidates staging systems for adults and children; ICD9. The asterisks before the category numbers indicate
simplifies surveillance criteria for opportunistic illnesses; and that these codes were not part of the original ICD9.
incorporates clinical criteria for reporting diagnoses without
HIV infection was formerly referred to as human T-cell
laboratory evidence. (See HIV Surveillance Report, 2014; vol.
lymphotropic virus-III/lymphadenopathy-associated virus
26. 2015.)
(HTLVIII/LAV) infection. Before 1987, deaths involving HIV
infection were classified to Deficiency of cell-mediated
The 2008 case definition was used to classify cases
diagnosed from the beginning of the epidemic through immunity (ICD9, code 279.1) contained in the category
2013. In order to classify HIV infection among both adults All other diseases; to Pneumocystosis (ICD9, code 136.3)
and adolescents, the following HIV infection classification contained in the category All other infectious and parasitic
staging system was used: diseases; to Malignant neoplasms, including neoplasms
of lymphatic and hematopoietic tissues; and to a number
of other causes. Because of these coding changes, death
HIV infection, stage 1: No AIDS-defining condition and statistics for HIV infection before 1987 are not strictly
either a CD4 count of 500 cells/L or more or a CD4 comparable with data for 1987 and subsequent years and
percentage of total lymphocytes of 29% or more.
therefore are not shown in Health, United States.
HIV infection, stage 2: No AIDS-defining condition
and either a CD4 count of 200499 cells/L or a CD4 (Also see Appendix II, Acquired immunodeficiency
percentage of total lymphocytes of 14%28%. syndrome [AIDS]; Cause of death; International Classification
HIV infection, stage 3 (AIDS): Documentation of an of Diseases [ICD]; International Classification of Diseases, 9th
AIDS-defining condition, or either a CD4 count of Revision, Clinical Modification [ICD9CM]; Table IV.)
less than 200 cells/L or a CD4 percentage of total
lymphocytes of less than 14%. Documentation of an HypercholesterolemiaSee Appendix II, Cholesterol.
AIDS-defining condition supersedes a CD4 count or
percentage that would not by itself be the basis for a HypertensionSee Appendix II, Blood pressure, high.
stage 3 (AIDS) classification.
HIV infection, stage unknown: No reported information ICD; ICD codesSee Appendix II, Cause of death;
on AIDS-defining conditions and no information International Classification of Diseases (ICD).
available on CD4 count or percentage (see MMWR
2008;57[RR10]:18). Illicit drug useIllicit drug use refers to the use and misuse
of illegal and controlled drugs.
The 2014 case definition was used to classify cases
diagnosed beginning in 2014 and is similar to the 2008 case Monitoring the Future (MTF) StudyIn this school-
definition except for the following: (a) inclusion of criteria based survey of secondary school students,
for stage 0, (b) inclusion of CD4 testing criteria for stage 3 in information on illicit drug use is collected using
children, and (c) changes in cutoffs for CD4 percentages of self-completed questionnaires. The information is
total lymphocytes used for classifications of stages 1 and 2 based on the following questions: On how many
in persons aged 6 years and over. The 2014 case definition occasions (if any) have you used marijuana in the last
classifies HIV infection based on the following stages: 30 days? Similar questions are asked about lifetime
and past year use of marijuana and a range of other
HIV infection, stage 0: First positive HIV test result drugs, including hallucinogens, inhalants, cocaine,
within 6 months after negative test result. After 6 heroin, and so on. Questions on cocaine use include
months, the stage may be reclassified as 1, 2, 3, or the following: On how many occasions (if any) have
unknown. you taken crack (cocaine in chunk or rock form) during
the last 30 days? and On how many occasions (if
HIV infection, stages 1, 2, and 3: Documentation of an any) have you taken cocaine in any other form during
AIDS-defining condition (excluding stage 0) is stage 3. the last 30 days? Starting in 2014, the question on
Otherwise, the stage is determined by the lowest CD4 MDMA asks, On how many occasions (if any) have
test result.
you taken MDMA (ecstasy or Molly) during the past
436 Appendix II. Definitions and Methods Health, United States, 2016
30 days? Previously, the question only asked about Industry of employmentFor the presentation of data in
ecstasy use before Molly (a nickname for a supposedly Health, United States, industries are classified according to
stronger form of MDMA) became a popular form the North American Industry Classification System (NAICS).
of the drug. Questions about prescription drugs NAICS groups establishments into industries based on
tranquilizers, sedatives, narcotic drugs other than their production or supply function. Establishments using
heroin, and amphetaminesprovide a description similar raw material inputs, capital equipment, and labor
of the legitimate uses for those drugs and then ask are classified in the same industry. This approach creates
respondents to include only use on your own, that homogeneous categories well suited for economic analysis.
is, without a doctor telling you to take them. NAICS uses a six-digit hierarchical coding system to classify
all economic activity. The first two digits of the six-digit
National Survey on Drug Use & Health (NSDUH) code designate the highest level of aggregation, into the
Information on illicit drug use is collected for survey public administration (government) and 20 private industry
participants aged 12 and over. Information on any illicit sectors (Table VIII). Agriculture, forestry, fishing and hunting;
drug use includes any use of marijuana or hashish, mining, quarrying, and oil and gas extraction; construction;
cocaine, crack, heroin, hallucinogens, inhalants, or and manufacturing are primarily goods-producing sectors,
methamphetamine, as well as misuse of prescription and the remaining 16 sectors are entirely service providing.
psychotherapeutic drugs. Current use (within the past NAICS allows for the classification of more than 1,000
month) is based on the question: How long has it industries. For more information on NAICS, see: http://www.
been since you last used [drug name]?This answer census.gov/eos/www/naics.
is cross-checked with the following question: Think
specifically about the past 30 days, from [DATE] up Starting in 1997, NAICS replaced the Standard Industrial
to and including today. During the past 30 days, on Classification (SIC) system, which was last updated in 1987.
how many days did you use [drug name]? Starting The SIC system focused on the manufacturing sector of
in 2013, information about marijuana use that was the economy and provided significantly less detail for the
recommended by a doctor or other health care now-dominant service sector, including newly developed
professional has been collected; however, reported industries in information services, health care delivery, and
marijuana use is classified as illicit drug use. Starting high-technology manufacturing. Although some titles in SIC
in 2015, NSDUH questionnaire underwent a partial and NAICS are similar, there is little comparability between
redesign, and changes in measurement for 7 of the the two systems because industry groupings are defined
10 illicit drug categorieshallucinogens, inhalants, differently. Estimates classified by NAICS should not be
methamphetamine, and the misuse of prescription compared with estimates that used SIC.
pain relievers, tranquilizers, stimulants, and
sedativesmay have affected the comparability of the Infant deathAn infant death is the death of a live-born
measurement of these illicit drugs and any illicit drug. child before his or her first birthday. Age at death may be
(Also see Appendix II, Substance use.) further classified as neonatal or postneonatal. Neonatal
deaths are those that occur before the 28th day of life;
ImmunizationSee Appendix II, Vaccination. postneonatal deaths are those that occur within 28 days to
under 1 year of age. (Also see Appendix II, Rate: Death and
IncidenceIncidence is the number of cases of disease related rates.)
having their onset during a prescribed period of time. It is
often expressed as a rate (e.g., the incidence of measles per InjuryThe International Classification of External Causes
1,000 children aged 515 during a specified year). Measuring of Injuries (ICECI) Coordination and Maintenance Group
incidence may be complicated because the population at defines injury as a (suspected) bodily lesion resulting from
risk for the disease may change during the period of interest acute overexposure to energy (this can be mechanical,
due to births, deaths, or migration, for example. In addition, thermal, electrical, chemical, or radiant) interacting with
determining whether a case is newthat is, whether its the body in amounts or rates that exceed the threshold of
onset occurred during the prescribed period of time physiological tolerance. The time between exposure to the
may be difficult. Because of these difficulties in measuring energy and the appearance of an injury is short. In some
incidence, many health statistics are instead measured in cases, an injury results from an insufficiency of any of the
terms of prevalence. (Also see Appendix II, Prevalence.) vital elements (i.e., air, water, or warmth), as in strangulation,
drowning, or freezing. Acute poisonings and toxic effects,
IncomeSee Appendix II, Family income. including overdoses of substances and wrong substances
given or taken in error are included, as are adverse effects
Individual practice association (IPA)See Appendix II, and complications of therapeutic, surgical, and medical care.
Health maintenance organization (HMO). Psychological harm is excluded. Injuries can be intentional
or unintentional (i.e., accidental). In NCHS data systems,
external causes of nonfatal injuries are currently coded
to the International Classification of Diseases, 9th Revision,
437 Appendix II. Definitions and Methods Health, United States, 2016
Clinical Modification, Supplementary Classification of Table VIII. Codes for industries, based on the North
External Causes of Injury and Poisoning, and the codes are American Industry Classification System (NAICS)
often referred to as E codes. See Table IX for a list of external
Industry Code
causes of injury categories and E codes used in Health,
United States. Also see the NCHS injury website at: http:// Agriculture, forestry, fishing and hunting . . . . . 11
Mining, quarrying, and oil and gas extraction . . . 21
www.cdc.gov/nchs/injury.htm; and see: ICECI Coordination
Utilities. . . . . . . . . . . . . . . . . . . . . . . 22
and Maintenance Group. International Classification of
Construction. . . . . . . . . . . . . . . . . . . . 23
External Causes of Injuries (ICECI), ver 1.2. Amsterdam, Manufacturing . . . . . . . . . . . . . . . . . . . 3133
The Netherlands: Consumer Safety Institute; and Adelaide, Wholesale trade . . . . . . . . . . . . . . . . . . 42
Australia: Australian Institute of Health and Welfare National Retail trade . . . . . . . . . . . . . . . . . . . . 4445
Injury Surveillance Unit, Flinders University; 2004. Available Transportation and warehousing . . . . . . . . . 4849
from: http://www.who.int/classifications/icd/adaptations/ Information . . . . . . . . . . . . . . . . . . . . 51
iceci/en/index.html. (Also see Appendix II, Diagnosis; Injury- Finance and insurance . . . . . . . . . . . . . . 52
related visit.) Real estate and rental and leasing . . . . . . . . 53
Professional, scientific, and technical services . . 54
Management of companies and enterprises . . . 55
Injury-related visitIn the National Hospital Ambulatory Administrative and support and waste
Medical Care Survey (NHAMCS), an emergency department management and remediation services . . . . . 56
visit was considered injury-related if the physician diagnosis Educational services . . . . . . . . . . . . . . . 61
was injury-related or an external cause-of-injury code (E Health care and social assistance. . . . . . . . . 62
code) was present (Table IX). Starting with Health, United Arts, entertainment, and recreation . . . . . . . . 71
Accommodation and food services . . . . . . . . 72
States, 2008, an injury-related visit was redefined as an
Other services, except public administration . . . 81
initial injury visit. In the 20012010 NHAMCS, an initial
Public administration . . . . . . . . . . . . . . . 92
injury visit was the first visit to an emergency department
for an injury that was characterized by either the first-listed SOURCE: Bureau of Labor Statistics. Available from: http://www.census.gov/
diagnosis being a valid injury diagnosis or by a valid first- eos/www/naics/.
listed E code, regardless of the diagnosis code. Visits for
which the first-listed diagnosis or the first-listed E code
was for a complication of medical care or for an adverse Instrumental activities of daily living (IADL)IADLs
event were not counted as injury visits. For 20012004 and are activities related to independent living and include
preparing meals, managing money, shopping for groceries
2007 and subsequent data years, the patient record form
or personal items, performing light or heavy housework, and
had a specific question on whether the episode of care
using a telephone. In the National Health Interview Survey,
was an initial visit for the problem. In the 2005 and 2006
respondents are asked whether they or family members
surveys, this variable was not included, and in its place an
need the help of another person for handling routine IADL
imputed variable was constructed that indicated whether needs because of a physical, mental, or emotional problem.
the visit was or was not the initial visit for the problem.
For an explanation of the methodology used to create the In the Medicare Current Beneficiary Survey, if a sample
imputed initial visit variable, see: http://www.cdc.gov/nchs/ person had any difficulty performing an activity by him- or
data/ahcd/initialvisit.pdf. For more information, see the herself and without special equipment or did not perform
NCHS Injury Data and Resources website at: http://www. the activity at all because of health problems, the person
cdc.gov/nchs/injury.htm; and Fingerhut LA. Recommended was categorized as having a limitation in that activity. The
definition of initial injury visits to emergency departments limitation may have been temporary or chronic at the time
for use with the NHAMCSED data. NCHS. Health E-Stats; of interview. Sampled persons in the community answered
2006. Available from: http://www.cdc.gov/nchs/data/ health status and functioning questions themselves, if able
hestat/injury/injury.htm. (Also see Appendix II, Emergency to do so. For sampled persons in a long-term care facility,
department or emergency room visit; External cause of a proxy, such as a nurse, answered questions about the
injury; Injury.) sampled persons health status and functioning. (Also see
Appendix II, Activities of daily living [ADL]; Complex activity
InpatientAn inpatient is a person who is formally limitation; Limitation of activity.)
admitted to the inpatient service of a hospital for
observation, care, diagnosis, or treatment. (Also see InsuranceSee Appendix II, Health insurance coverage.
Appendix II, Admission; Average length of stay; Days of care;
Discharge; Hospital.) Intermediate care facilitySee Appendix II, Nursing home.
Inpatient careSee Appendix II, Hospital utilization. International Classification of Diseases (ICD)The ICD is
used to code and classify cause-of-death data. The ICD is
Inpatient daySee Appendix II, Days of care. developed collaboratively by the World Health Organization
and 10 international centers, one of which is housed at
NCHS. The purpose of the ICD is to promote international
438 Appendix II. Definitions and Methods Health, United States, 2016
Table IX. Codes for external causes of injury, from the International Classification of Diseases, 9th Revision,
Clinical Modification
External cause of injury category E code
SOURCE: Recommended framework of E code groupings for presenting injury morbidity data. Available from: http://www.cdc.gov/injury/wisqars/ecode_matrix.html,
and the International Classification of Diseases, 9th Revision, Clinical Modification. Available from: http://www.cdc.gov/nchs/icd/icd9cm.htm.
comparability in the collection, classification, processing, Classification of Diseases, Functioning, and Disability
and presentation of health statistics. Since 1900, the ICD has website at: http://www.cdc.gov/nchs/icd.htm. (Also see
been modified about once every 10 years, except for the Appendix II, International Classification of Diseases [ICD];
20-year interval between the 9th and 10th revisions (ICD9 International Classification of Diseases, 10th Revision, Clinical
and ICD10) (Table III). The purpose of the revisions is to Modification/Procedure Coding System [ICD10CM/PCS].)
stay abreast of advances in medical science. New revisions
usually introduce major disruptions in time series of International Classification of Diseases, 10th Revision,
mortality statistics (Tables IV and V). For more information, Clinical Modification/Procedure Coding System (ICD10
see the NCHS ICD10 website at: http://www.cdc.gov/ CM/PCS)Use of ICD10CM/PCS to report medical
nchs/icd/icd10.htm. (Also see Appendix II, Cause of death; diagnoses and inpatient procedures was implemented
Comparability ratio; International Classification of Diseases, October 1, 2015. The transition to ICD10 is required for
9th Revision, Clinical Modification [ICD9CM].) everyone covered by the Health Insurance Portability and
Accountability Act (HIPAA). This change to ICD10 does
International Classification of Diseases, 9th Revision, not affect Current Procedural Terminology (CPT) coding
Clinical Modification (ICD9CM)ICD9CM is based for outpatient procedures and physician services. ICD10
on, and is compatible with, the World Health Organizations CM/PCS consists of two parts: ICD10CM for diagnosis
ICD9. The United States used ICD9CM to code morbidity coding, and ICD10PCS for inpatient procedure coding.
diagnoses and inpatient procedures until October 1, 2015, For more information about ICD10CM/PCS, see the
when the International Classification of Diseases, 10th NCHS Classification of Diseases, Functioning, and Disability
Revision, Clinical Modification/Procedure Coding System went website at: http://www.cdc.gov/nchs/icd.htm and the
into effect. ICD9CM consists of three volumes. Volumes 1 Centers for Medicare & Medicaid Services ICD10 transition
and 2 contain the diagnosis tabular list and index; Volume 3 website at: http://www.cms.gov/Medicare/Coding/ICD10/
contains the procedure classification (tabular list and index index.html.
combined).
Late fetal death rateSee Appendix II, Rate: Death and
ICD9CM is divided into 17 chapters and two supplemental related rates.
classifications. The chapters are arranged primarily by body
system. In addition, there are chapters for Infectious and Leading causes of deathSee Appendix II, Cause-of-death
parasitic diseases; Neoplasms; Endocrine, nutritional, and ranking.
metabolic diseases; Mental disorders; Complications of
pregnancy, childbirth, and puerperium; Certain conditions Length of staySee Appendix II, Average length of stay.
originating in the perinatal period; Congenital anomalies;
and Symptoms, signs, and ill-defined conditions. The two Life expectancyLife expectancy is the average number
supplemental classifications are for factors influencing of years of life remaining to a person at a particular age
health status and contact with health services (V codes), and and is based on a given set of age-specific death rates
for external causes of injury and poisoning (E codes). generally the mortality conditions existing in the period
mentioned. Life expectancy may be determined by sex,
In Health, United States, morbidity data will be classified race and Hispanic origin, or other characteristics, by using
using ICD9CM until 2016 data are available and then age-specific death rates for the population with that
morbidity data will be classified using International characteristic. (Also see Appendix II, Rate: Death and related
Classification of Diseases, 10th Revision, Clinical Modification/ rates.)
Procedure Coding System (ICD10CM/PCS). ICD9CM
procedure categories and codes are shown in Table X.
U.S. life tables by Hispanic origin were available starting with
For more information about ICD9CM, see the NCHS
2006 data. Life expectancy data for the Hispanic population
439 Appendix II. Definitions and Methods Health, United States, 2016
were not available before 2006 for three major reasons: (a) of a chronic condition. Limitation of activity is assessed
coverage of the Hispanic population in the U.S. mortality by asking persons a series of questions about limitations
statistics system was incomplete, (b) misclassification of in their or a family members ability to perform activities
Hispanic persons on death certificate data underestimated usual for their age group because of a physical, mental, or
deaths in the Hispanic population, and (c) misstatement of emotional problem. Persons are asked about limitations
age at the oldest ages in the Hispanic population led to an in activities of daily living, instrumental activities of daily
underestimation of mortality at the oldest ages. living, play, school, work, difficulty walking or remembering,
and any other activity limitations. For reported limitations,
Hispanic origin was added to the U.S. standard death the causal health conditions are determined, and persons
certificate in 1989, but it was not adopted by every state are considered limited if one or more of these conditions
until 1997. By 1997, all states had reporting rates over 99%. is chronic. Children under age 18 who receive special
Research on race and Hispanic origin reporting on U.S. death education or early intervention services are considered to
certificates found that misclassification of race and Hispanic have a limitation of activity. (Also see Appendix II, Activities
origin accounts for a net underestimate of 5% for total of daily living [ADL]; Instrumental activities of daily living
Hispanic deaths and 1% for total non-Hispanic black deaths, [IADL].)
and a net overestimate of 0.5% for non-Hispanic white
deaths. To address the effects of age misstatement at the Long-term care facilityA long-term care facility is a
oldest ages, the probability of death for Hispanic persons residence that provides a specific level of personal or
over age 80 is estimated as a function of non-Hispanic white medical care or supervision to residents. In the Medicare
mortality with the use of the Brass relational logit model. Current Beneficiary Survey, a residence is considered a long
For more information, see: Arias E. United States life tables term care facility if it has three or more long-term care beds
by Hispanic origin. NCHS. Vital Health Stat 2010;2(152). and answers affirmatively to at least one of three questions:
Available from: http://www.cdc.gov/nchs/data/series/sr_02/ Does this facility (a) provide personal care services to
sr02_152.pdf. residents, (b) provide continuous supervision of residents,
(c) provide any long-term care?Types of long-term care
In 2000, the life table methodology was revised. The revised facilities include licensed nursing homes, skilled nursing
methodology is similar to that developed for the 19992001 homes, intermediate care facilities, retirement homes (that
decennial life tables. In 2008, the life table methodology provide services), domiciliary or personal care facilities,
was refined in two important ways. First, a logistic rather distinct long-term care units in a hospital complex, mental
than a nonlinear least squares model was used to smooth health facilities and centers, assisted and foster care homes,
and extrapolate the Vital and Medicare blended death rates assisted living facilities, and institutions for persons with
at the older ages. Second, the age at which smoothing is intellectual disabilities (formerly called mentally retarded)
begun was raised from 66 to 85 years or so, depending and the developmentally disabled. (Also see Appendix II,
on the population. Values for 2001 and subsequent data Nursing home.)
years shown in Health, United States are based on the 2008
revision of the life table methodology. As a result, data Low birthweightSee Appendix II, Birthweight.
post-2000 may differ from figures published previously.
For a full description of the 2008 life table methodology, MammographyA mammogram is an x-ray image of the
see: Arias E. United States life tables, 2008. National vital breast used to detect irregularities in breast tissue. In the
statistics reports; vol 61 no 3. Hyattsville, MD: NCHS; 2012. National Health Interview Survey, questions concerning
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr61/ use of mammography are asked on an intermittent
nvsr61_03.pdf. Starting with Health, United States, 2016, life schedule, and question content has differed across years.
expectancy estimates for 2010 and beyond were revised to Mammograms may be used for diagnostic or screening
reflect updated race and Hispanic origin classification ratios. purposes, but the purpose cannot be determined from NHIS.
See: Arias E, Heron M, Hakes JK. The validity of race and
In Health, United States, use of mammography was defined
Hispanic-origin reporting on death certificates in the United
as percent of women having a mammogram within the
States: An update. NCHS. Vital Health Stat 2(172). 2016.
past two years. Survey questions have changed over time as
Available from: http://www.cdc.gov/nchs/data/series/sr_02/
follows.
sr02_172.pdf. Additional life table estimates are available
from the life table home page at: http://www.cdc.gov/nchs/ In 1987 and 1990, women were asked to report the number
products/life_tables.htm. of days, weeks, months, or years that had passed since their
most recent mammogram. In 1991, women were asked
Limitation of activityLimitation of activity may be whether they had a mammogram in the past 2 years. In
defined in different ways, depending on the conceptual 1993 and 1994, women were asked whether they had a
framework. In the National Health Interview Survey, mammogram within the past year, between 1 and 2 years
limitation of activity refers to a long-term reduction in a ago, or over 2 years ago. In 1998, women were asked
persons capacity to perform the usual kind or amount of whether they had a mammogram a year ago or less, more
activities associated with his or her age group as a result than 1 year but not more than 2 years, more than 2 years
440 Appendix II. Definitions and Methods Health, United States, 2016
Table X. Codes for procedure categories for Healthcare Cost and Utilization Project data, from the International
Classification of Diseases, 9th Revision, Clinical Modification
Procedure category Code
NOTES: Procedures were classified by the Clinical Classifications Software (CCS). For more information, see:
http://www.hcup-us.ahrq.gov/toolssoftware/ccs/AppendixBSinglePR.txt.
ago but not more than 3 years, more than 3 years but not In 2005, women were asked the same series of
more than 5 years, or over 5 years ago. mammography questions as in the 2000 and 2003 surveys,
but the questionnaire skip pattern was modified so that
In 1999, women were asked to report the number of days, more women were asked the follow-up question using the
weeks, months, or years that had passed since their most 1998 wording. Thus, estimates for 2005 and subsequent
recent mammogram. Estimates for 1999 may be slightly years are more precise than estimates for 1999, 2000, and
overestimated in comparison with previous years: women 2003. SAS code to categorize mammography data for 2000
who responded 2 years ago (10% of women) may include and beyond is available from: http://www.cdc.gov/nchs/
those who received a mammogram more than 2 years but nhis/nhis_2005_data_release.htm. In 2008, 2010, 2013, and
less than 3 years ago.
2015, the mammography questions were identical to those
asked in 2005.
In 2000 and 2003, women were asked when they had
their most recent mammogram (asked to give month and
year). Women who did not respond were given a follow- The recommended age to begin mammography screening
up question that used the 1999 wording, and women and the interval between screenings has changed over time.
who did not respond to the 1999 wording were asked a The current recommendation, made by the U.S. Preventive
second follow-up question that used the 1998 wording. Services Task Force in 2016, is the use of screening
Estimates for 2000 and 2003 may be slightly overestimated mammography for breast cancer every 2 years in women
in comparison with estimates prior to 1999: women who aged 5074, with additional guidance provided for women
responded 2 years ago (2% of women) may include those aged 4049. For additional information, see: U.S. Preventive
who received a mammogram more than 2 years but less Services Task Force. Breast cancer: Screening. Rockville, MD:
than 3 years ago. Agency for Healthcare Research and Quality; 2016.
441 Appendix II. Definitions and Methods Health, United States, 2016
Available from: http://www.uspreventiveservicestaskforce. providers are usually physicians, physician group practices,
org/Page/Document/RecommendationStatementFinal/ or entities employing or having other arrangements
breast-cancer-screening1; and U.S. Preventive Services with such physicians, but they can also include nurse
Task Force. Guide to clinical preventive services, 2014. practitioners, nurse midwives, or physician assistants. These
Rockville, MD: Agency for Healthcare Research and Quality; providers (also called gatekeepers) contract directly with
2014. Available from: http://www.ahrq.gov/professionals/ the state to locate, coordinate, and monitor covered primary
clinicians-providers/guidelines-recommendations/guide/ care (and sometimes additional services). PCCM providers
index.html. are paid a per-patient case management fee and usually
do not assume financial risk for the provision of services.
Managed careManaged care is a term originally used to Some states allow Medicaid enrollees to voluntarily enroll in
refer to prepaid health plans (generally, health maintenance managed care plans; most states require that at least certain
organizations, or HMOs) that furnish care through a network categories of Medicaid beneficiaries join such plans. Both
of providers under a fixed budget and manage costs. MCOs and PCCM arrangements include plans that provide
Increasingly, the term is also used to include preferred specialized services to certain categories of Medicaid
provider organizations (PPOs) and even forms of indemnity beneficiaries. For more information on state Medicaid
insurance coverage (i.e., fee-for-service insurance). managed care plans, see http://www.medicaid.gov/.
Medicare managed care includes a combination of risk- (Also see Appendix II, Health maintenance organization
and cost-based plans. Risk-based plans receive a fixed [HMO]; Medicare; Medicaid; Preferred provider organization
prepayment per beneficiary per month to help pay for the [PPO].)
cost of all covered services that a beneficiary may use. Each
year, the Centers for Medicare & Medicaid Services (CMS) Marital statusMarital status is classified through self-
announces a benchmark amount for each county for reporting into the categories married and unmarried. The
coverage of Medicare Part A and Part B services. A managed term married encompasses all married people, including
care plan contracting with Medicare then submits a bid, those separated from their spouses. Unmarried includes
which represents the revenue it needs to cover these those who are single (never married), divorced, or widowed.
services. If the bid is above the benchmark, the difference
must be charged in a premium to the enrollees of the plan. Birth fileIn 1970, 39 states and D.C., and in 1975,
If the bid is below the benchmark, then a portion of the 38 states and D.C., included a direct question about
difference must be used to provide additional benefits mothers marital status on the birth certificate. Since
to enrollees, with the Medicare trust funds receiving the 1980, national estimates of births to unmarried women
remaining share. The term Medicare Advantage is used to have been based on two methods for determining
refer to managed care plans, including HMOs, PPOs, private marital status: a direct question in the birth registration
fee-for-service plans, special needs plans, Medicare medical process and inferential procedures. In 19801996,
savings account plans, and certain other types of plans. marital status was reported on the birth certificates of
4145 states and D.C.; with the addition of California in
Cost-based plans are offered by an HMO or a competitive 1997, 46 states and D.C.; and in 19982001, 48 states
medical plan and are paid for their reasonable costs in and D.C. In 1997, all but four states (Connecticut,
providing Medicare services to enrollees, based on annual Michigan, Nevada, and New York), and in 1998, all but
cost reports filed with CMS. For current definitions of two states (Michigan and New York) included a direct
the various Medicare managed care plans, see the CMS question about mothers marital status on their birth
Medicare Managed Care Manual. Ch 1, section 30, Types certificates. In 19982007, marital status was imputed
of MA Plans, Baltimore, MD: CMS; 2011. Available from: as married on birth records with missing information
https://www.cms.gov/Regulations-and-Guidance/Guidance/ in the 48 states and D.C. where this information was
Manuals/Internet-Only-Manuals-IOMs-Items/CMS019326. obtained by a direct question. In 20082013 for 49
html?DLPage=1&DLEntries=100&DLSort=0&DLS%20 states and D.C., marital status is reported in the birth
ortDir=ascending. registration process.
442 Appendix II. Definitions and Methods Health, United States, 2016
and Nevada has been determined by a direct question Adultsfor those with incomes up to 138% of the federal
in the birth registration process. Beginning in June 15, poverty level (FPL) (133% by statute with an additional 5%
1998, Connecticut discontinued inferring the mothers income disregard). This is discussed further below.
marital status and added a direct question regarding
mothers marital status to the states birth certificate. States set individual eligibility criteria within federal
minimum standards. In addition to Medicaids financial
In 2005, Michigan added a direct question to the birth eligibility requirements, individuals must satisfy federal and
registration process but uses inferential procedures state requirements regarding residency, immigration status,
to update information collected using the direct and documentation of U.S. citizenship. The ACA provided
question. In both Michigan and New York, a birth is a standard applicationavailable through the Medicaid
inferred as nonmarital if either of these factors, listed program or through the Health Insurance Marketplaceand
in priority-of-use order, is present: (a) a paternity
a standard method for calculating income eligibility for
acknowledgment was received or (b) the fathers name
Medicaid, CHIP, and insurance affordability programs offered
is missing. For 20062008 data, inferential procedures
through the marketplace, based primarily on modified
were used to compile birth statistics by marital
status, in full or in part, for New York and Michigan, adjusted gross income (MAGI). Effective 2014, MAGI is
respectively. For 20092014, mothers marital status is used to determine Medicaid and CHIP eligibility for most
inferred for New York. nondisabled children and adults under age 65.
National Health Interview Survey (NHIS)In NHIS, Broadly, there are four major eligibility groups covered by
marital status is asked of, or about, all persons aged most states: Children, Adults with Disabilities, Aged Adults,
14 and over. Respondents are asked, Are you now and Nondisabled Adults. These are discussed in more detail
married, widowed, divorced, separated, never married, below.
or living with a partner?
Major Eligibility Groups
Maternal ageSee Appendix II, Age.
ChildrenMedicaid was originally available only to
MedicaidMedicaid was authorized in 1965 and became individuals receiving cash assistance, but Congress
Title XIX of the Social Security Act. Medicaid is a jointly has since expanded eligibility for children and other
funded cooperative venture between the federal and populations, making individuals eligible based on
state governments to assist states in the provision of income below a specified percentage of the FPL.
adequate medical care to eligible persons. Within broad The ACA raised the minimum Medicaid eligibility for
federal guidelines, each state establishes its own eligibility nondisabled children to 138% FPL (133% by statute
standards; determines the type, amount, duration, and with an additional 5% income disregard). Other
scope of services; sets the rate of payment for services; and eligible child groups include: infants born to women
administers its own program. covered by Medicaid (known as deemed newborns),
certain children in foster care or adoption assistance
Medicaid is the largest program providing medical and programs, certain children with disabilities, and
health-related services to low income individuals. Medicaid children who use long-term services and supports.
was originally available only to individuals receiving cash Like disabled adults, most states automatically qualify
assistance, but over time, Congress has expanded eligibility disabled children in the Supplemental Security Income
for children and selected adult groups. Most recently, (SSI) program for Medicaid coverage; eligibility is not
the Affordable Care Act (ACA) and the Health Care and determined by the newly introduced MAGI. Some
Education Reconciliation Act (HCERA) initiated significant states use more restrictive criteria to determine
changes to Medicaid. (Subsequent references to the ACA in Medicaid eligibility of children with SSI. These criteria
this text will include changes enacted by either the ACA or are usually based on income relative to the FPL and
HCERA.) assets. Regardless of how they qualify, all children
enrolled in Medicaid are entitled to the comprehensive
States are mandated by federal law to cover certain set of health care services known as Early, Periodic
population groups (mandatory eligibility groups) but Screening, Diagnostic and Treatment (EPSDT). These
are granted flexibility in covering other groups (optional services include screening for and treatment of any
eligibility groups). In the standard benefit package, states vision or hearing problems, coverage for eyeglasses
must cover mandatory benefits (e.g., physician services) but and hearing aids, and regular preventive dental care
may choose to cover optional benefits (e.g., tuberculosis- and treatment.
related services). Prior to the ACA, many states expanded
Medicaid coverage above the federal minimums and many Adults with DisabilitiesAdults with disabilities from
states have chosen to continue this additional coverage. The physical conditions, intellectual or development
major coverage change introduced by the ACA was to create disabilities, serious behavioral disorders, or serious
a new eligibility groupMedicaid Expansion to Low-Income mental illness may be eligible for Medicaid. The
443 Appendix II. Definitions and Methods Health, United States, 2016
Supplemental Security Income (SSI) program pays Like coverage for adults with disabilities, states
benefits to disabled adults and children who have may extend Medicaid coverage to adults with low
limited income and resources. Enrollment in SSI (or incomes or high medical expenses through other
the Social Security Disability Insurance program, eligibility pathways, such as covering those with higher
which provides Medicare to qualified individuals after income levels or those with chronic conditions or
a 24-month waiting period) automatically qualifies low functional status requiring institutionalization or
adults with disabilities for Medicaid in most states. significant home-based services. There is considerable
However, some states use more restrictive criteria variation across states in the optional Medicaid
(known as 209(b) of the 1972 amendments to the services covered, which results in different benefits for
Social Security Act) to determine Medicaid eligibility. dual-eligible beneficiaries depending on where they
medically necessary.
(e.g., pregnant women, low-income parents, or other
alternative to institutionalization; permitting working Prevention and Treatment Program and Tuberculosis
individuals who are severely impaired but whose (TB)are discussed below.
disabilities who use long-term services and supports October 2016, 31 states and D.C. had chosen to expand
based on their functional status (known as level-of their Medicaid programs. They are: Alaska, Arizona,
care) and use of services (e.g., residence in a nursing Arkansas, California, Colorado, Connecticut, Delaware,
facility, intermediate care facility for persons with Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana,
requiring significant home-based services). Montana, Nevada, New Hampshire, New Jersey,
Aged AdultsThe Supplemental Security Income Pennsylvania, Rhode Island, Vermont, Washington, and
enrollment automatically qualified those aged 65 and Medicaid to cover pregnant women with low income.
older for Medicaid. However, some states use more Currently, all but four states have extended Medicaid
restrictive criteria (known as 209(b)) to determine coverage to pregnant women above the currently
Medicaid eligibility. The more restrictive criteria may required level of 138% FPL. Maternity-related services
consider income and assets, disability, or both. Most covered by the programs include prenatal care, labor
Medicaid enrollees aged 65 or over are also Medicare and delivery, and 60 days of postpartum care. In
beneficiaries. Members of this group are known as Medicaid-expansion states, women at or below 138%
dual-eligible beneficiaries. Dual eligibles are eligible FPL who are pregnant when they apply for Medicaid
for the same Medicare benefits as other Medicare are not eligible for the new adult group. Medicaid
beneficiaries but have low incomes that make it coverage as a pregnant woman ends two months
difficult to afford the premiums and cost sharing postpartum (after which the individual may be eligible
required by Medicare, as well as the cost of services in another Medicaid eligibility group).
444 Appendix II. Definitions and Methods Health, United States, 2016
Parents and Caretaker RelativesParents and caretaker (Also see Appendix II, Childrens Health Insurance Program
relatives in low-income families with dependent [CHIP]; Health expenditures, national; Health insurance
children are eligible for coverage if their income meets coverage; Health maintenance organization [HMO];
the minimum eligibility levels established in 1996 Managed care; and Appendix I, Medicaid Statistical
for financial and medical assistance, which averages Information System [MSIS].)
41% of poverty. (1996 was the year of enactment
for welfare reform, which held in place guaranteed Medicaid paymentsUnder the Medicaid program,
Medicaid eligibility for those receiving cash benefits medical vendor payments are payments (expenditures)
at that time.) States have the option to be more or less to medical vendors from the state through a fiscal agent,
restrictive than the 1996 standards. or to a health insurance plan. Adjustments are made for
cost settlements, third-party recoupments, refunds, voided
Adults without Dependent ChildrenPrior to the ACA, checks, and financial settlements that cannot be related
about one-half of states provided some coverage, to specific provided claims. Medicaid medical vendor
through Medicaid demonstration projects or state- payments presented in Health, United States do not include
funded programs, for nondisabled adults who had payments made to providers from other federal programs
limited incomes but did not otherwise qualify for or from third party payers for Medicaid-eligible individuals;
Medicaid. Currently, 31 states and the District of payments made from state medical assistance funds that
Columbia have implemented the ACA Medicaid are not federally matchable; cost sharing or enrollment fees
expansion for adults with incomes at or below 133% collected from recipients or a third party; and administration
of the poverty line (with a 5% income disregard, so and training costs. Medicaid payment data presented
effectively 138%). in Health, United States are from the Medical Statistical
Information System (MSIS), which obtains payment data
from electronic Medicaid data submitted to the Centers
Other Eligibility Groups
for Medicare & Medicaid Services by each state. Payment
Breast and Cervical Cancer Prevention and Treatment data are based on adjudicated claims for medical services
ProgramIn 2000, Congress passed the Breast and reimbursed with Title XIX funds.
Cervical Cancer Prevention and Treatment Act, which
allowed states to offer eligible women, who were Medical specialtySee Appendix II, Physician specialty.
diagnosed with cancer through the CDC-funded
screening program, access to treatment through MedicareMedicare is a nationwide program providing
Medicaid. All states and D.C. have chosen to provide health insurance coverage to selected groups, regardless
this coverage. For a woman to be eligible under this of income. The covered groups are (a) most people aged 65
option, she must be under age 65; been screened and over; (b) people entitled to Social Security or Railroad
through CDCs National Breast and Cervical Cancer Retirement disability benefits for at least 24 months (with
Early Detection Program; be diagnosed with either the waiting period waived or reduced in certain situations);
breast or cervical cancer, including precancerous (c) government employees or spouses with Medicare-only
conditions; need treatment for breast or cervical
coverage who have been disabled for more than 29 months
cancer; and be uninsured and otherwise not eligible
(with the waiting period waived or reduced in certain
for Medicaid.
situations); (d) most people with end-stage renal disease;
Tuberculosis (TB)States can choose to provide and (e) certain people in the Libby, Montana, vicinity
Medicaid coverage of TB-related services for low- who are diagnosed with asbestos-related conditions. The
income individuals who are infected with TB. program was enacted on July30, 1965, as Title XVIII of the
This eligibility group serves individuals who are Social Security Act, Health Insurance for the Aged and
not otherwise eligible for Medicaid based on the Disabled, and became effective on July 1, 1966.
traditional eligibility categories.
From its inception, Medicare has included two separate
Medicaid operates as a vendor payment program. States but coordinated programs: Hospital Insurance (Part A) and
may pay health care providers directly on a fee-for-service Supplementary Medical Insurance (Part B). Part C (Medicare
basis, or states may pay for Medicaid services through Advantage) was established by the Balanced Budget Act of
various prepayment arrangements, such as through 1997 (originally as Medicare+Choice) as an expanded set
Medicaid managed care organizations (MCOs) or other of options for the delivery of health care under Medicare.
forms of managed care. Within federally imposed upper Although all Medicare beneficiaries can receive their
limits and restrictions, each state generally has broad benefits through the original fee-for-service program, most
discretion in determining both the payment method beneficiaries enrolled in both Part A and Part B have the
and rate for services. Thus, the Medicaid program varies option to participate in a Medicare Advantage plan instead.
considerably from state to state, as well as within each state
over time. For more information, see: http://www.medicaid. Organizations that seek to contract as Medicare Advantage
gov/ and https://www.macpac.gov/. plans must meet specific organizational, financial, and other
requirements. Although most Medicare Advantage enrollees
445 Appendix II. Definitions and Methods Health, United States, 2016
are in coordinated care plans, such as health maintenance National Health Interview Survey (NHIS)For
organizations and preferred provider organizations, respondents to NHIS, designation of place of residence
Medicare Advantage plans also include private fee-for as metropolitan or nonmetropolitan is based on the
service plans, provider-sponsored organizations, special following MSA definitions: for 2006 and beyond, on
needs plans, medical savings account plans (MSA plans, the June 2003 OMB definitions (2000 OMB standards
which provide benefits after a single high deductible is applied to 2000 census data); for 19952005, on the
met), and certain other types of plans. Medicare Advantage June 1993 OMB definitions (1990 OMB standards
plans are generally paid on a capitation basisthat is, plans applied to 1990 census data); and for 19851994, on
are paid a predetermined amount per member per month, the June 1983 OMB definitions (1980 OMB standards
which is adjusted according to the health status of the applied to 1980 census data). For estimates based on
plans membersand are required to provide at least those 2006 NHIS data combined with earlier years of NHIS,
services covered by Parts A and B, except hospice services. metropolitan status of residence for all years involved
Plans may (and in certain situations must) provide extra is based on the June 2003 definitions. Introduction
benefits (such as vision or hearing coverage) or reduce cost of each set of standards may create a discontinuity in
sharing or premiums. trends.
The Medicare Prescription Drug, Improvement, and National Immunization Survey (NIS)Since 2013,
Modernization Act (also called the Medicare Modernization designation of place of residence as metropolitan or
Act, or MMA) was passed on December 8, 2003. The MMA nonmetropolitan for NIS respondents is based on 2010
(Pub. L. 108173) established a voluntary prescription Census data and the MSAs delineated in February
drug benefit for Medicare beneficiaries and created a new 2013. For data prior to 2013, designation of place of
Medicare Part D. People eligible for Medicare could begin residence as metropolitan or nonmetropolitan for
to enroll in Part D beginning in January 2006. For more NIS respondents was based on 2000 census data and
information on Medicare, see: https://www.medicare.gov/ the MSAs delineated in 2003, as well as the following
Pubs/pdf/10050.pdf and http://www.cms.gov/Research versions and revisions of MSA definitions: for 2011
Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ and 2012, on the December 2009 definitions; for
MedicareMedicaidStatSupp/2013.html. (Also see Appendix 2010, on the November 2008 definitions, for New
II, Fee-for-service health insurance; Health insurance England, the county-based areas were used; for 2009,
coverage; Health maintenance organization [HMO]; on the November 2007 definitions, for New England,
Managed care; and Appendix I, Medicare Administrative the county-based areas were used; for 2008, on the
Data.) December 2006 definitions, for New England, the
county-based areas were used; for quarter 4 of 2007,
Metropolitan statistical area (MSA)The Office of on the December 2006 definitions; for quarters 13
Management and Budget (OMB) defines MSAs according to of 2007, on the December 2005 definitions, for New
published standards that are applied to U.S. Census Bureau England, the county-based areas were used in 2007;
data. The standards are revised periodically, generally prior for 2006, on the November 2004 definitions, for New
to the decennial census, and are applied to the census data England, the county-based areas were used; for 2005,
to delineate the statistical areas. Revisions to the areas on the December 2003 definitions, for New England,
are implemented between censuses by using updated the county-based areas were used; for quarters 3 and
population estimates. The most recent standards were 4 of 2004, on the December 2003 definitions; and for
released in June 2010 (available from: https://www.census. quarters 1 and 2 of 2004 and quarter 4 of 2003, on
gov/programs-surveys/metro-micro.html). In July 2015, OMB the June 2003 definitions. For 20032004 for New
released a new delineation of the nations metropolitan and England, the county-based areas were used. For more
micropolitan statistical areas based on the 2010 standards information, see: https://www.census.gov/programs
(available from: https://www.census.gov/programs-surveys/ surveys/metro-micro.html.
metro-micro.html). New MSA delineations are incorporated
into individual data systems at different times. In the
2000 and 2010 standards, an MSA is a county, or group of Micropolitan statistical areaThe Office of Management
contiguous counties, that contains at least one urbanized and Budget (OMB) defines a micropolitan statistical area
area with a population of 50,000 or more. In addition to the as a nonmetropolitan county, or group of contiguous
county or counties that contain all or part of the urbanized nonmetropolitan counties, that contains an urban cluster
area, an MSA may contain other counties if there are strong of 10,00049,999 persons. A micropolitan statistical area
social and economic ties with the central county or counties, may include surrounding counties that have strong social
as measured by commuting. Counties that are not within and economic ties with the central county or counties as
an MSA are considered to be nonmetropolitan. For more measured by commuting. Nonmetropolitan counties that
information, see: https://www.census.gov/programs are not classified as part of a micropolitan statistical area are
surveys/metro-micro.html. Most data by MSA currently considered noncore.
in Health, United States are based on the June 2003 OMB
definitions (2000 OMB standards applied to 2000 census
data). (Also see Appendix II, Urbanization.) OMB defines micropolitan statistical areas according to
published standards that are applied to U.S. Census Bureau
446 Appendix II. Definitions and Methods Health, United States, 2016
data. The standards are revised periodically, generally classification levels might be changed (e.g., alendronate
prior to the decennial census, and are applied to the now has three classification levels: metabolic agents [level
census data to delineate the statistical areas. Revisions 1], bone resorption inhibitors [level 2], and bisphosphonates
to the areas are implemented between censuses using [level 3]); under the prior drug information file, alendronate
updated population estimates. The most recent standards had two classification levels: hormones [level 1] and
were released in June 2010 (available from: https://www. bisphosphonates [level 2]. Data presented in Health, United
census.gov/programs-surveys/metro-micro.html). OMB States used the most recent drug information file for all data
released a new delineation of the nations metropolitan and years.
micropolitan statistical areas based on the 2010 standards
in July 2015 (available from: https://www.census.gov/ For more information, see: http://wwwn.cdc.gov/nchs/
programs-surveys/metro-micro.html). Data for micropolitan nhanes/1999-2000/RXQ_DRUG.htm.
statistical areas currently in Health, United States are based
on the 2013-based delineation as part of the 2013 NCHS Neonatal mortality rateSee Appendix II, Rate: Death and
UrbanRural Classification Scheme for Counties. The related rates.
micropolitan statistical area data will be updated when the
new delineation is incorporated into individual data systems. Nonprofit hospitalSee Appendix II, Hospital.
447 Appendix II. Definitions and Methods Health, United States, 2016
average daily census divided by the number of hospital referred visits, observation services, outpatient surgeries,
beds, cribs, and pediatric bassinets set up and staffed on the and emergency department visits. In the National Hospital
last day of the reporting period, expressed as a percentage. Ambulatory Medical Care Survey, an outpatient department
Average daily census is calculated by dividing the total visit is a direct personal exchange between a patient and
annual number of inpatients, excluding newborns, by 365 a physician or other health care provider working under
days to derive the number of inpatients receiving care on the physicians supervision for the purpose of seeking care
an average day during the annual reporting period. The and receiving personal health services. (Also see Appendix
occupancy rate for facilities other than hospitals is calculated II, Emergency department or emergency room visit;
as the number of residents at the facility reported on the Outpatient department.)
day of interview, divided by the number of reported beds.
In the Centers for Medicare & Medicaid Services Quality OverweightSee Appendix II, Body mass index (BMI).
Improvement Evaluation System (QIES) (formerly the Online
Survey Certification and Reporting [OSCAR]) database, Pap smearA Pap smear (also known as a Papanicolaou
occupancy is determined as of the day of certification smear or Pap test) is a microscopic examination of cells
inspection as the total number of residents on that day scraped from the cervix that is used to detect cancerous
divided by the total number of beds on that day. or precancerous conditions of the cervix or other medical
conditions.
Office-based physicianSee Appendix II, Physician.
In the National Health Interview Survey, questions
concerning Pap smear use are asked on an intermittent
Office visitIn the National Ambulatory Medical Care
schedule, and the question content has differed slightly
Survey, a physicians ambulatory practice (office) can be in
across years. For 2015, women were asked when they had
any location other than in a hospital, nursing home, other
their most recent Pap smear, and use of Pap smears was
extended care facility, patients home, industrial clinic,
defined as percent of women having a Pap smear within the
college clinic, or family planning clinic. Offices in health
past three years. Survey questions have changed over time.
maintenance organizations and private offices in hospitals
are included. An office visit is any direct personal exchange
In 1987, women were asked to report either the month
between an ambulatory patient and a physician or members
and year of their Pap smear or the amount of time (in days,
of his or her staff for the purpose of seeking care and
weeks, months, or years) elapsed since their last Pap smear.
rendering health services. (Also see Appendix II, Outpatient
Women who did not respond were asked, Was it within
visit.)
the past year or a year or more ago?Those who answered
within the past year were asked to further clarify whether
OperationSee Appendix II, Procedure.
the Pap smear was less than 3 months or 3 more months
ago, and those who answered a year or more ago were
Outpatient departmentAccording to the National
asked to further clarify whether the Pap smear was 3 years
Hospital Ambulatory Medical Care Survey (NHAMCS), an
or less, between 3 and 5 years, or 5 or more years ago. In
outpatient department (OPD) is a hospital facility where
1990 and 1991, Pap smear data in the past 3 years were not
nonurgent ambulatory medical care is provided. The
available. In 1993 and 1994, women were asked whether
following types of OPDs are excluded from NHAMCS:
they had a Pap smear within the past year, between 1 and 3
ambulatory surgical centers, chemotherapy, employee
health services, renal dialysis, methadone maintenance, and years ago, or more than 3 years ago. In 1998, women were
radiology. (Also see Appendix II, Emergency department; asked whether they had a Pap smear 1 year ago or less, more
Outpatient visit.) than 1 year but not more than 2 years ago, more than 2
years but not more than 3 years ago, more than 3 years but
Outpatient surgeryAccording to the American Hospital not more than 5 years ago, or more than 5 years ago.
Association, outpatient surgery is a surgical operation,
whether major or minor, performed on a patient who does In 1999, women were asked when they had their most
not remain in the hospital overnight. Outpatient surgery recent Pap smear (time elapsed in days, weeks, months, or
may be performed in inpatient operating suites, outpatient years). Women who did not respond were asked whether
surgery suites, or procedure rooms within an outpatient they had a Pap smear a year ago or less, more than 1 year
care facility. A surgical operation involving more than one but not more than 2 years ago, more than 2 years but not
surgical procedure is considered one surgical operation. more than 3 years ago, more than 3 years but not more
(Also see Appendix II, Procedure.) than 5 years ago, or over 5 years ago. Estimates for 1999
may be slightly overestimated in comparison with estimates
Outpatient visitThe American Hospital Association for previous years due to the inclusion of women who
defines outpatient visits as visits for receipt of medical, responded 3 years ago (4% of women), which could have
dental, or other services at a hospital by patients who included more than 3 years but less than 4 years.
are not lodged in the hospital. Each appearance by
an outpatient to each unit of the hospital is counted In 2000 and 2003, women were asked when they had their
individually as an outpatient visit, including all clinic visits, most recent Pap smear (month and year). Women who did
448 Appendix II. Definitions and Methods Health, United States, 2016
not respond were given a follow-up question that used they had not had a Pap smear; one reason women could
the 1999 wording, and women who did not respond to the select was had a hysterectomy. In 1993, 1994, 1998,
follow-up question were asked a second follow-up question 1999, 2013, and 2015, women were asked, Have you
that used the 1998 wording. Estimates for 2000 and 2003 had a hysterectomy? In 2000, 2005, 2008, and 2010, two
may be slightly overestimated in comparison with years questions were used to determine whether women had
prior to 1999 due to the inclusion of women who responded had a hysterectomy. Women were asked, Have you had
3 years ago (less than 1% of women), which could have a hysterectomy? In addition, women who reported that
included more than 3 years but less than 4 years. they had not had a recent Pap smear were asked the most
important reason they had not had a Pap smear; one reason
In 2005, women were asked the same series of questions women could select was had hysterectomy. Women
about Pap smear use as in the 2000 and 2003 surveys, but indicating in either of these questions that they had had a
the questionnaire skip pattern was modified so that more hysterectomy were excluded from the Health, United States
women were asked the follow-up question using the 1998 estimates for the group Percent of women having a Pap
wording, and these women were not uniformly coded smear within the past 3 years, among those who have not
as having had a Pap smear within the past 3 years. Thus, had a hysterectomy.
estimates for 2005 are more precise than estimates for 1999,
2000, and 2003. SAS code to categorize Pap smear data for PatientSee Appendix II, Inpatient; Office visit; Outpatient
visit.
2000 and beyond is available from: http://www.cdc.gov/
nchs/nhis/nhis_2005_data_release.htm.
Percent change/percentage changeSee Appendix II,
Average annual rate of change (percent change).
In 2008, 2010, 2013, and 2015 Pap smear questions were
similar to those asked in 2005.
Perinatal mortality rate; ratioSee Appendix II, Rate:
Death and related rates.
All women aged 18 and over were asked the Pap
smear question(s). Women who reported having had a
Personal care home with or without nursingSee
hysterectomy (removal of the uterus, with or without
Appendix II, Nursing home.
removal of the ovaries and cervix) were still asked the
Pap smear questions because a woman who has had a
Personal health care expendituresSee Appendix II,
hysterectomy may still have had Pap smear testing.
Health expenditures, national.
The current general recommendation, made by the U.S.
Physical activity, leisure-timeStarting with Health,
Preventive Services Task Force (USPSTF) in 2012, is the
United States, 2010, estimates on leisure-time physical
use of Pap smears for cervical cancer every 3 years in
activity changed to reflect the federal 2008 Physical Activity
women aged 2165, with additional recommendations
available for women aged 3065 who want to lengthen the Guidelines for Americans (available from: http://www.health.
recommended screening interval. In Health, United States, gov/PAGuidelines/guidelines/default.aspx). Adults who
2014, additional age groups (1820, 2124, and 2144) met the 2008 guidelines reported at least 150 minutes
were added to account for the new recommendation. per week of moderate-intensity or 75 minutes per week of
However, these recommendations were undergoing vigorous-intensity aerobic physical activity (or an equivalent
review by the USPSTF at the time this report was combination of moderate- and vigorous-intensity aerobic
prepared. For a summary of current Pap smear testing activity) and muscle-strengthening activities at least twice
recommendations and the status of the review, see: https:// a week. The estimates for the percentage of Americans who
www.uspreventiveservicestaskforce.org/Page/Document/ met the 2008 guidelines for aerobic physical activity and
UpdateSummaryFinal/cervical-cancer-screening. muscle strengthening are not comparable with estimates
in previous editions of Health, United States that showed
The USPSTF recommends against routine Pap smear the percentage of Americans with regular leisure-time
screening in women who have had a total hysterectomy physical activity. For more information, see: Carlson SA,
for benign disease. Therefore, two measures of Pap smear Fulton JE, Schoenborn CA, Loustalot F. Trend and prevalence
screening are presented in Health, United States: one among estimates based on the 2008 Physical Activity Guidelines for
all women and one among women who did not report Americans. Am J Prev Med 2010;39(4)30513.
having a hysterectomy, although it is not known from NHIS
data whether, for women who did report a hysterectomy, Starting with 1998 data, leisure-time physical activity has
it was for benign disease. Questions about whether the been assessed in the National Health Interview Survey
respondent had a hysterectomy were not asked in 2003. For (NHIS) by asking adults a series of questions about how
other survey years, questions about hysterectomy in NHIS often they do vigorous or light/moderate physical activity
differed slightly, as follows. of at least 10 minutes duration and about how long these
sessions generally last. All questions related to leisure-time
In 1987, women who reported that they had not had a physical activity were phrased in terms of current behavior
recent Pap smear were asked the most important reason and lack a specific reference period. Vigorous physical
449 Appendix II. Definitions and Methods Health, United States, 2016
activity is described as causing heavy sweating or a large area of specialty. Physician data are broadly categorized into
increase in breathing or heart rate and light/moderate as two areas of practice: those who provide primary care and
causing light sweating or a slight-to-moderate increase in those who provide specialty care.
breathing or heart rate. Adults were also asked about how
often they did leisure-time physical activities specifically Primary care generalistThese physicians practice in
designed to strengthen their muscles, such as lifting weights the general fields of family medicine, general practice,
or doing calisthenics. The 2008 guidelines recommend any internal medicine, obstetrics and gynecology, and
kind of aerobic activity, not just leisure-time aerobic activity, pediatrics. Specifically excluded are primary care
so the leisure-time aerobic activity estimates presented in specialists associated with these generalist fields.
this report may underestimate the percentage of adults
who met the 2008 guidelines for aerobic activity. For more Primary care specialistThese specialists practice in the
information, see the NHIS Adult Physical Activity Information primary care subspecialties of family medicine, internal
website at: http://www.cdc.gov/nchs/nhis/physical_activity. medicine, obstetrics and gynecology, and pediatrics.
Family medicine subspecialties include geriatric
htm.
medicine and sports medicine. Internal medicine
subspecialties include adolescent medicine, critical
PhysicianData on physician characteristics are obtained
care medicine, diabetes, endocrinology, diabetes and
through physician self-report from the American Medical metabolism, hematology, hepatology, hematology/
Associations (AMA) Physician Masterfile. Although the AMA oncology, cardiac electrophysiology, infectious
collects data for both doctors of medicine (MDs) and doctors diseases, clinical and laboratory immunology, geriatric
of osteopathy (DOs), in Health, United States data for DOs medicine, sports medicine, nephrology, nutrition,
come from the American Osteopathic Association. medical oncology, pulmonary critical care medicine,
and rheumatology. Obstetrics and gynecology
Active (or professionally active) physicianThese subspecialties include hospice and palliative
physicians are currently engaged in patient care medicine (obstetrics and gynecology), maternal
or other professional activity for a minimum of 20 and fetal medicine, critical care medicine (obstetrics
hours per week. Other professional activity includes and gynecology), and reproductive endocrinology.
administration, medical teaching, research, and other Pediatric subspecialties include adolescent medicine,
activities such as employment with insurance carriers, pediatric critical care medicine, pediatrics/internal
pharmaceutical companies, corporations, voluntary medicine, neonatal-perinatal medicine, pediatric
organizations, and medical societies. Physicians who allergy, pediatric cardiology, pediatric endocrinology,
are retired, semiretired, working part-time, or not pediatric infectious disease, pediatric pulmonology,
practicing are classified as inactive and are excluded. medical toxicology (pediatrics), pediatric emergency
Also excluded are physicians with unknown address medicine, pediatric gastroenterology, pediatric
and physicians who did not provide information hematology/oncology, clinical and laboratory
on type of practice or present employment (not immunology (pediatrics), pediatric nephrology,
classified). pediatric rheumatology, and sports medicine
(pediatrics).
Hospital-based physicianThese physicians are
Specialty care physicianThese physicians are
employed under contract with hospitals to provide
sometimes called specialists and include primary
direct patient care and include physicians in residency
care specialists listed above in addition to all other
training (including clinical fellows) and full-time
physicians not included in the generalist definition.
members of the hospital staff.
Specialty fields include allergy and immunology,
aerospace medicine, anesthesiology, cardiovascular
Office-based physicianThese physicians are engaged
diseases, child and adolescent psychiatry, colon and
in seeing patients in solo practice, group practice, two-
rectal surgery, dermatology, diagnostic radiology,
physician practice, other patient care employment, or
forensic pathology, gastroenterology, general surgery,
in providing inpatient services such as those offered by
medical genetics, neurology, nuclear medicine,
pathologists and radiologists.
neurological surgery, occupational medicine,
ophthalmology, orthopedic surgery, otolaryngology,
Data for physicians are presented by type of education
psychiatry, public health and general preventive
(doctor of medicine or doctor of osteopathy); place of
medicine, physical medicine and rehabilitation, plastic
education (U.S. medical graduates and international surgery, anatomic and clinical pathology, pulmonary
medical graduates); activity status (professionally diseases, radiation oncology, thoracic surgery, urology,
active and inactive); area of specialty; and geographic addiction medicine, critical care medicine, legal
area. (Also see Appendix II, Physician specialty.)
medicine, and clinical pharmacology.
Physician specialtyA physician specialty is any specific
(Also see Appendix II, Physician.)
branch of medicine in which a physician may concentrate.
Data are based on physician self-reports of their primary
450 Appendix II. Definitions and Methods Health, United States, 2016
PopulationThe U.S. Census Bureau collects and publishes Census Bureaus poverty threshold website at: http://www.
data on populations in the United States according to census.gov/data/tables/time-series/demo/income-poverty/
several different definitions. Various statistical systems historical-poverty-thresholds.html.
then use the appropriate population for calculating rates.
(Also see Appendix I, Population Census and Population The second poverty measure used in Health, United States
Estimates.) is a ratio of family income to the HHS poverty guidelines.
Poverty guidelines are derived from the U.S. Census Bureaus
Resident population includes persons whose usual poverty thresholds and are issued annually by HHS. These
place of residence (i.e., the place where one usually guidelines are often used to determine eligibility in certain
lives and sleeps) is in one of the 50 states or D.C. It federal programs. The HHS poverty guidelines take into
includes members of the Armed Forces stationed account family size and state (coterminous, Alaska, Hawaii),
in the United States and their families. It excludes but not family composition. For more information, see HHS,
members of the Armed Forces stationed outside Office of the Assistant Secretary for Planning and Evaluation.
the United States and civilian U.S. citizens whose Poverty Guidelines, Research, and Measurement website at:
usual place of residence is outside the United States. http://aspe.hhs.gov/poverty/index.cfm.
The resident population is the denominator used
to calculate birth and death rates and incidence of National Health Interview Survey (NHIS)For data years
disease. prior to 1997, a ratio of family income to U.S. Census
Bureau poverty threshold was computed taking into
Civilian population is the resident population excluding account family income and family size. Starting with
members of the Armed Forces, although families 1997 data, the poverty ratio was based on family
of members of the Armed Forces are included. The income, family size, and family composition (number
civilian population is the denominator for emergency of children in the family, and for families with two or
department visit rates using the National Hospital fewer adults the age of the adults in the family). (Also
Ambulatory Medical Care SurveyEmergency see Appendix II, Consumer Price Index [CPI]; Family
Department Component. income; and Appendix I, Current Population Survey
[CPS]; National Health Interview Survey [NHIS].)
Civilian noninstitutionalized population is the civilian
population excluding persons residing in institutions National Health and Nutrition Examination Survey
(such as nursing homes, prisons, jails, mental hospitals, (NHANES)NHANES uses the U.S. Census Bureaus
and juvenile correctional facilities). U.S. Census Current Population Survey (CPS) definition of family
to group household members into a family unit. A
Bureau estimates of the civilian noninstitutionalized
poverty ratio is computed by dividing family income
population are used to calculate sample weights
by the HHS poverty guidelines specific to family size, as
for the National Health Interview Survey, the
well as the appropriate guideline year, and state. See:
National Health and Nutrition Examination Survey,
Johnson CL, Paulose-Ram R, Ogden CL, et al. National
and the National Survey of Family Growth, and as
Health and Nutrition Examination Survey: Analytic
denominators for rates calculated for the National
guidelines, 19992010. NCHS. Vital Health Stat 2(161).
Ambulatory Medical Care Survey and the National 2013. Available from: http://www.cdc.gov/nchs/data/
Hospital Ambulatory Medical Care SurveyOutpatient series/sr_02/sr02_161.pdf.
Department Component.
Preferred provider organization (PPO)A PPO is a type of
Postneonatal mortality rateSee Appendix II, Rate: Death medical plan in which coverage is provided to participants
and related rates. through a network of selected health care providers, such
as hospitals and physicians. Enrollees may seek care outside
PovertyTwo related versions of federal poverty measures the network but pay a greater percentage of the cost of
are shown in Health, United States. The first measurea coverage than within the network. (Also see Appendix II,
ratio of family income to federal poverty thresholdis Health maintenance organization [HMO]; Managed care.)
constructed using poverty thresholds from the U.S. Census
Bureau. Poverty thresholds are updated annually for inflation PrevalencePrevalence is the number of cases of a disease,
by the Census Bureau using the Consumer Price Index for number of infected persons, or number of persons with
all urban consumers (CPIU). Poverty thresholds include some other attribute present during a particular interval
a set of money income thresholds that vary by family size of time. It is often expressed as a rate (e.g., the prevalence
and composition but do not vary geographically. Families of diabetes per 1,000 persons during a year). (Also see
or individuals with income below the appropriate threshold Appendix II, Incidence.)
are classified as below poverty. For example, the weighted
average poverty threshold for a family of four was $24,257 Primary care specialtySee Appendix II, Physician
in 2015, $24,230 in 2014, $22,314 in 2010, $17,603 in 2000, specialty.
and $13,359 in 1990. For more information, see the U.S.
451 Appendix II. Definitions and Methods Health, United States, 2016
Private expendituresSee Appendix II, Health in price levels between countries. PPPs show the ratio of
expenditures, national. prices in national currencies for the same good or service in
different countries. PPPs can be used to make intercountry
ProcedureProcedures can include surgical procedures comparisons of the gross domestic product (GDP) and
(such as appendectomies), diagnostic procedures (such as its component expenditures. (Also see Appendix II, Gross
spinal taps), and therapeutic treatments (such as infusion domestic product [GDP].)
of a cancer chemotherapeutic substance) reported on a
patients medical record. In Health, United States, procedures RaceIn 1977, the Office of Management and Budget
are coded according to the International Classification of (OMB) issued Race and Ethnic Standards for Federal
Diseases, 9th Revision, Clinical Modification (ICD9CM) Statistics and Administrative Reporting (Statistical Policy
until 2016 data are available, and then procedures will be Directive 15) to promote comparability of data among
classified using the International Classification of Diseases, federal data systems. The 1977 Standards called for the
10th Revision, Clinical Modification/Procedure Coding System federal governments data systems to classify individuals
(ICD10CM/PCS). into the following four racial groups: American Indian or
Alaskan Native, Asian or Pacific Islander, black, and white.
Healthcare Cost and Utilization Project, National Depending on the data source, the classification by race
(Nationwide) Inpatient Sample (HCUPNIS)Currently, was based on self-classification or on observation by an
up to 15 procedures are coded using ICD9CM interviewer or other person filling out the questionnaire.
procedure codes per hospital stay in the HCUPNIS
database. Starting with 2016 data, procedures will be In 1997, revisions were announced for classification
coded according to the International Classification of of individuals by race within the federal governments
Diseases, 10th Revision, Clinical Modification/Procedure data systems. (See: Revisions to the standards for the
Coding System. For each record, a principal procedure classification of federal data on race and ethnicity. Fed Regist
is identified as the first procedure listed. HCUPNIS 1997 October 30;62(210):5878190.) The 1997 Standards
procedure data presented in Health, United States specify five racial groups: American Indian or Alaska Native,
are limited to operating room procedures that are Asian, black or African American, Native Hawaiian or Other
principal procedures (first-listed). Valid operating Pacific Islander, and white. These five categories are the
room procedures were identified according to minimum set for data on race in federal statistics. The 1997
diagnosis-related groups (DRGs) software. For DRG Standards also offer an opportunity for respondents to
development, physician panels classify all ICD9CM select more than one of the five groups, leading to many
procedure codes based on whether the procedure possible multiple-race categories. As with the single-race
would be performed in operating rooms in most groups, data for the multiple-race groups are to be reported
hospitals. Clinical Classifications Software (CCS) was when estimates meet agency requirements for reliability
used to categorize ICD9CM principal operating and confidentiality. The 1997 Standards allow for observer
room procedure codes into 1 of 231 clinically or proxy identification of race but clearly state a preference
meaningful categories. CCS was developed at the for self-classification. The federal government considers
Agency for Healthcare Research and Quality as a tool race and Hispanic origin to be two separate and distinct
for clustering patient procedures into a manageable concepts. Thus, Hispanic persons may be of any race.
number of clinically meaningful categories. It is Federal data systems were required to comply with the 1997
periodically updated. For more information on CCS, Standards by 2003.
see: http://www.hcup-us.ahrq.gov/toolssoftware/ccs/
AppendixBSinglePR.txt. The top-ranking operating National Health Interview Survey (NHIS)Starting with
room procedure categories by age group, based on Health, United States, 2002, race-specific estimates
the number of discharges and total national costs, based on NHIS were tabulated using the 1997
are presented in Health, United States (Table X). CCS Standards for data year 1999 and beyond and are not
categories labeled other are not presented because strictly comparable with estimates for earlier years.
these comprise miscellaneous procedures that do not The 1997 Standards specify five single-race categories
form a homogeneous group. plus multiple-race categories. Estimates for specific
race groups are shown when they meet requirements
(Also see Appendix II, Outpatient surgery.) for statistical reliability and confidentiality. The race
categories white only, black or African American only,
Proprietary hospitalSee Appendix II, Hospital. American Indian or Alaska Native only, Asian only,
and Native Hawaiian or Other Pacific Islander only
Public expendituresSee Appendix II, Health include persons who reported only one racial group;
expenditures, national. the category 2 or more races includes persons who
reported more than one of the five racial groups in the
Purchasing power parities (PPPs)PPPs are calculated 1997 Standards or one of the five racial groups and
some other race. In order to maintain consistency
rates of currency conversion that equalize the purchasing
with the Census Bureau procedures for collecting and
power of different currencies by eliminating the differences
editing data on race and ethnicity, the NHIS made
452 Appendix II. Definitions and Methods Health, United States, 2016
major changes to its editing procedures in the 2003 To improve the quality of data on ethnicity and race
data year. Beginning in the 2003 NHIS, Other race was in NHIS, hot-deck imputation of selected race and
no longer available as a separate race response. This ethnicity variables was done for the first time in the
response category was treated as missing, and the 2000 NHIS and continued to be used for subsequent
race was imputed if this was the only race response. data years. Starting with 2003 data, records for persons
In cases where Other race was mentioned along with for whom other race was the only race response
one or more race groups, the Other race response was were treated as having missing data on race and were
dropped, and the race group information was retained. added to the pool of records for which selected race
and ethnicity variables were imputed. Prior to the
Prior to data year 1999, data were tabulated according
to the 1977 Standards, with four racial groups, and the 2000 NHIS, a crude imputation method that assigned
Asian only category included Native Hawaiian or Other a race to persons with missing values for the variable
Pacific Islander. Estimates for single-race categories MAINRACE (the respondents classification of the race
prior to 1999 included persons who reported one he or she most identified with) was used. Under these
race or, if they reported more than one race, identified procedures, if an observed race was recorded by the
one race as best representing their race. Differences interviewer, it was used to code a race value. If there
between estimates tabulated using the two standards was no observed race value, all persons who had a
for data year 1999 are discussed in the footnotes for missing value for MAINRACE and were identified as
each NHIS table in Health, United States 2002, 2003, and Hispanic on the Hispanic origin question were coded
2004 editions. Available from: https://www.cdc.gov/ as white. In all other cases, non-Hispanic persons were
nchs/hus/previous.htm#editions. coded as other race. Additional information on the
NHIS methodology for imputing race and ethnicity is
Tables XI and XII illustrate NHIS data tabulated by available from the survey documentation at: http://
race and Hispanic origin according to the 1997 and www.cdc.gov/nchs/nhis/quest_data_related_1997_
1977 Standards for two health statistics (cigarette forward.htm and from the NHIS race and Hispanic
smoking and private health insurance coverage). In
origin home page at: http://www.cdc.gov/nchs/nhis/
these examples, three separate tabulations using
rhoi.htm.
the 1997 Standards are shown: (a) Race: mutually
exclusive race groups, including several multiple-race
combinations; (b) Race, any mention: race groups that National Health and Nutrition Examination Survey
are not mutually exclusive because each race category (NHANES)Starting with Health, United States, 2003,
includes all persons who mention that race; and (c) race-specific estimates based on NHANES were
Hispanic origin and race: detailed race and Hispanic tabulated using the 1997 Standards for data years
origin with a multiple-race total category. 1999 and beyond. Prior to data year 1999, the 1977
Standards were used. Because of the differences
Where applicable, comparison tabulations by race between the two standards, the race-specific estimates
and Hispanic origin are shown based on the 1977 shown in Trend Tables based on NHANES for 1999 and
Standards. Because there are more race groups with beyond are not strictly comparable with estimates for
the 1997 Standards, the sample size of each race group earlier years. Race in NHANES I and II was determined
under the 1997 Standards is slightly smaller than the primarily by interviewer observation; starting
sample size under the 1977 Standards. Only those with NHANES III, race was self-reported by survey
few multiple-race groups with sufficient numbers of participants.
observations to meet standards of statistical reliability
are shown. These tables also illustrate changes in
The NHANES sample for data years 19992006 was
labels and group categories resulting from the 1997
Standards. The race designation black was changed designed to provide estimates specifically for persons
to black or African American, and the ethnicity of Mexican origin and not for all Hispanic-origin
designation Hispanic was changed to Hispanic or persons in the United States. Persons of Hispanic
Latino. origin other than Mexican origin were entered into the
sample with different selection probabilities that are
Survey data included in Health, United States, other not nationally representative of the total U.S. Hispanic
than NHIS, the National Survey of Drug Use & Health population. Starting with 20072008 data, all Hispanic
(NSDUH), and the National Health and Nutrition persons were oversampled, not just persons of
Examination Survey (NHANES), generally do not Mexican origin. Oversampling of the black population
permit tabulation of estimates for the detailed race was continued. Starting in 2011, NHANES oversampled
and ethnicity categories shown in Tables XI and XII, the non-Hispanic Asian population. In Health, United
either because race data based on the 1997 Standards States, estimates are shown for non-Hispanic white,
categories are not yet available or because there non-Hispanic black, and Mexican-origin persons,
are insufficient numbers of observations in certain as well as Hispanic-origin and non-Hispanic Asian
subpopulation groups to meet statistical reliability or
persons, where possible. Although data were collected
confidentiality requirements.
according to the 1997 Standards, there are insufficient
453 Appendix II. Definitions and Methods Health, United States, 2016
numbers of observations during this period to meet Census and Population Estimates, Bridged-race
statistical reliability or confidentiality requirements for Population Estimates.)
reporting estimates for additional race categories.
Starting with 2003 data, some states began using the
National Survey on Drug Use & Health (NSDUH)Race 2003 revision of the U.S. Standard Certificate of Live
specific estimates based on NSDUH are tabulated using Birth, which allows the reporting of more than one
the 1997 Standards. Estimates in the NSDUH Trend race (multiple races). For 2014 data, 49 states, D.C.,
Table begin with data year 2002. Estimates for specific Guam, and Northern Marianas allowed the reporting of
race groups are shown when they meet requirements multiple-race data. The 49 states and D.C. represented
for statistical reliability and confidentiality. The race 99% of all U.S. resident births. In 2014, multiple race
was reported for slightly more than 2% of mothers
categories white only, black or African American only,
in the states that permitted reporting of more than
American Indian or Alaska Native only, Asian only,
one race. In 2014, data from the vital records of the
and Native Hawaiian or Other Pacific Islander only remaining state, and two territories, followed the 1977
include persons who reported only one racial group; OMB Standards and reported the minimum set of four
the category 2 or more races includes persons who race categories, compared with the minimum of five
reported more than one of the five racial groups in the race categories for the 1997 Standards. To provide
1997 Standards or one of the five racial groups and uniformity and comparability of data during the
some other race. transition to the 2003 revision, before multiple-race
data are available for all reporting areas, the responses
National Vital Statistics System (NVSS)Some of the of those who reported more than one race are bridged
states in the Vital Statistics Cooperative Program are to a single race. For more information on the adoption
still revising their birth and death records to conform of the 2003 revision of the U.S. Standard Certificate
to the 1997 Standards on race and ethnicity. During of Live Birth, see the Technical Notes section of the
the transition to full implementation of the 1997 annual series of Births: Final Data reports, available
Standards, vital statistics data will continue to be from: http://www.cdc.gov/nchs/products/nvsr.htm.
presented for four major race groups (white, black or
Although the bridging procedure imputes multiple
African American, American Indian or Alaska Native,
race of mothers to one of the four minimum races
and Asian or Pacific Islander) in accordance with the
stipulated in the 1977 Standards, mothers of a
1977 Standards. specified Asian or Pacific Islander (API) subgroup
(Chinese, Japanese, Hawaiian, or Filipino) in
Birth fileInformation about the race and Hispanic combination with another race (American Indian or
origin of the mother and father is provided by the Alaska Native, black, and/or white) or another API
mother at the time of birth and is recorded on the subgroup cannot be imputed to a single API subgroup.
birth certificate or fetal death record. Since 1980, birth Data for the API subgroups are available in the 2014
rates, birth characteristics, and death rates for live- Natality public-use data file at: http://www.cdc.gov/
born infants and fetal deaths are presented in Health, nchs/births.htm.
United States according to race of the mother. Before
1980, data were tabulated by race of the newborn Mortality fileInformation about the race and Hispanic
and fetus, taking into account the race of both origin of a decedent is reported by the funeral director
parents. If the parents were of different races and one as provided by an informant (often the surviving
parent was white, the child was classified according next of kin), or in the absence of an informant, on the
to the race of the other parent. When neither parent basis of observation. Death rates by race and Hispanic
origin are based on information from death certificates
was white, the child was classified according to the
(numerators of the rates) and on population estimates
fathers race, with one exception: if either parent was
from the Census Bureau (denominators). Race and
Hawaiian, the child was classified Hawaiian. Before ethnicity information from the census is by self-
1964, if race was unknown, the birth was classified as report. To the extent that race and Hispanic origin are
white. Starting in 1964, unknown race was classified inconsistent between these two data sources, death
according to information on the birth record. Starting rates will be biased. Studies have shown that persons
with the 2000 census, the race and ethnicity data self-reported as American Indian, Asian, or Hispanic on
used for denominators (population) to calculate birth census and survey records may sometimes be reported
and fertility rates have been collected in accordance as white or non-Hispanic on the death certificate,
with the 1997 revised OMB standards for race and resulting in an underestimation of deaths and death
ethnicity. However, the numerators (births) will not rates for the American Indian, Asian, and Hispanic
be compatible with the denominators until all the groups. Bias also results from undercounts of some
states revise their birth certificates to reflect the new population groups in the censusparticularly young
standards. To compute rates, it is currently necessary black males, young white males, and elderly persons
to bridge population data for multiple-race persons to resulting in an overestimation of death rates.
single-race categories. (Also see Appendix I, Population
454 Appendix II. Definitions and Methods Health, United States, 2016
Table XI. Current cigarette smoking among adults aged 18 and over, by race and Hispanic origin under the 1997 and 1977
Standards for federal data on race and ethnicity: United States, average annual 19931995
Sample Standard Sample Standard
1997 Standards size Percent error 1977 Standards size Percent error
*Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%30%.
NOTES: The Office of Management and Budget's (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity specifies five
race groups (white, black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander) and allows respondents to report
one or more race groups. Estimates for single-race and multiple-race groups not shown above do not meet standards for statistical reliability or confidentiality (relative
standard error greater than 30%). Race groups under the 1997 Standards were based on the question, "What is the group or groups which represents [person's] race?"
For persons who selected multiple groups, race groups under the OMB's 1977 Race and Ethnic Standards for Federal Statistics and Administrative Reporting were
based on the additional question, "Which of those groups would you say best represents [person's] race?" Race-specific estimates in this table were calculated after
excluding respondents of other and unknown race. Other published race-specific estimates are based on files in which such responses have been edited. Estimates are
age-adjusted to the year 2000 standard population using five age groups: 1824, 2534, 3544, 4564, and 65 and over. See Appendix II, Age adjustment.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
Race and ethnicity reporting on the death certificate origin reporting on death certificates in the United
continues to be excellent for the white and black States: An update. NCHS. Vital Health Stat 2016:2 (172).
populations. It remains poor for the American Indian
or Alaska Native population but is reasonably good for Available from: http://www.cdc.gov/nchs/data/series/
the Hispanic and Asian or Pacific Islander populations. sr_02/sr02_172.pdf; Arias E, Schauman WS, Eschbach K,
Decedent characteristics such as place of residence et al. The validity of race and Hispanic origin reporting
and nativity have an important effect on the quality on death certificates in the United States. NCHS. Vital
of reporting on the death certificate. The effects of Health Stat 2008;2(148). Available from: http://www.
misclassification on mortality estimates were most cdc.gov/nchs/data/series/sr_02/sr02_148.pdf.
pronounced for the American Indian or Alaska Native
population, where correcting for misclassification Denominators for infant mortality rates are based on
reverses a large American Indian or Alaska Native the number of live births, rather than on population
over-white mortality advantage to a relatively large estimates. Race information for the denominator is
disadvantage. Among the Hispanic and Asian or Pacific supplied from the birth certificate. Before 1980, race of
Islander populations, adjustment for death certificate child for the denominator took into account the races
misclassification did not significantly affect minority- of both parents. Starting in 1980, race information for
majority mortality. For more information, see: Arias E, the denominator has been based solely on the race
Heron M, Hakes JK. The validity of race and Hispanic- of the mother. Race information for the numerator
455 Appendix II. Definitions and Methods Health, United States, 2016
Table XII. Private health care coverage among persons under age 65, by race and Hispanic origin under the 1997 and 1977
Standards for federal data on race and ethnicity: United States, average annual 19931995
Sample Standard Sample Standard
1997 Standards size Percent error 1977 Standards size Percent error
NOTES: The Office of Management and Budget's (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity specifies five
race groups (white, black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander) and allows respondents to report
one or more race groups. Estimates for single-race and multiple-race groups not shown above do not meet standards for statistical reliability or confidentiality (relative
standard error greater than 30%). Race groups under the 1997 Standards were based on the question, "What is the group or groups which represents [person's] race?"
For persons who selected multiple groups, race groups under the OMB's 1977 Race and Ethnic Standards for Federal Statistics and Administrative Reporting were
based on the additional question, "Which of those groups would you say best represents [person's] race?" Race-specific estimates in this table were calculated after
excluding respondents of other and unknown race. Other published race-specific estimates are based on files in which such responses have been edited. Estimates are
age-adjusted to the year 2000 standard population using three age groups: under 18, 1844, and 4564. See Appendix II, Age adjustment.
SOURCE: NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
is supplied from the death certificate. For the infant population, as enumerated by the U.S. Census Bureau.
mortality rate, race information for the numerator is In contrast, the Indian Health Service calculates vital
race of the deceased child. event rates for this population based on U.S. Census
Bureau county data for American Indian or Alaska
Issues affecting the interpretation of vital event rates Native persons who reside on or near reservations.
for the American Indian or Alaska Native population Because of misclassification of American Indian or
include (a) changes in the classification or self- Alaska Native persons on death certificates, American
identification of persons of American Indian or Alaska Indian or Alaska Native national and state-specific
Native heritage over time, and (b) misclassification of mortality estimates published in Health, United States
American Indian or Alaska Native persons on death should be interpreted with caution.
certificates by the funeral director or informant. Vital
event rates for the American Indian or Alaska Native Interpretation of trends for the Asian population in
population shown in Health, United States are based on the United States should take into account that this
the total U.S. resident American Indian or Alaska Native population more than doubled between 1980 and
456 Appendix II. Definitions and Methods Health, United States, 2016
1990, primarily because of immigration. Between 1990 questions, data about race and Hispanic ethnicity for
and 2000, the increase in the Asian population was the years prior to 1999 are not strictly comparable with
48% for persons reporting that they were Asian alone estimates for the later years. However, analyses of data
and 72% for persons who reported they were either collected between 1991 and 2003 have indicated that
Asian alone or Asian in combination with another race. the data are comparable across years and can be used
to study trends. See: Brener ND, Kann L, McManus T.
For more information on coding race by using vital A comparison of two survey questions on race and
statistics, see: NCHS. Vital statistics of the United States, ethnicity among high school students. Public Opin Q
vol I, Natality, and vol II, Mortality, part A, Technical 2003;67(2):22736.
appendix. Hyattsville, MD; published annually.
Available from: http://www.cdc.gov/nchs/nvss.htm. (Also see Appendix II, Hispanic origin; and Appendix I,
Population Census and Population Estimates.)
Starting with 2003 data, some states began using
the 2003 revision of the U.S. Standard Certificate of RateA rate is a measure of some event, disease, or
Death, which allows the reporting of more than one condition in relation to a unit of population, along with
race (multiple races). This change was implemented to some specification of time. (Also see Appendix II, Age
reflect the increasing diversity of the U.S. population adjustment; Population.)
and to be consistent with the decennial census. For
more information on states reporting of multiple-
race data, see the annual series of Deaths: Final Data Birth and related rates
reports, available from: http://www.cdc.gov/nchs/
products/nvsr.htm. Birth rate is calculated by dividing the number of
live births in a population in a year by the resident
To provide uniformity and comparability of data population. For census years, rates are based on
until all states are reporting multiple-race data, it has unrounded census counts of the resident population
been necessary to bridge the responses of those for as of April 1. For the noncensus years 19811989,
whom more than one race is reported (multiple race) rates are based on national estimates of the resident
to one single race. For more information, see: NCHS population as of July 1, rounded to thousands.
procedures for multiple-race and Hispanic origin Rounded population estimates for 5-year age groups
data: Collection, coding, editing, and transmitting. are calculated by summing unrounded population
Hyattsville, MD: NCHS; 2004. Available from: http:// estimates before rounding to thousands. Starting
www.cdc.gov/nchs/data/dvs/Multiple_race_docu_5 in 1991, rates are based on unrounded national
10-04.pdf; and NCHS. Vital statistics of the United population estimates. Birth rates for 19911999
States, vol I, Natality, and vol II, Mortality, part A, were revised based on the 1990 and 2000 censuses.
Technical appendix. Hyattsville, MD; published The rates for 1990, 2000, and 2010 are based on
annually. Available from: http://www.cdc.gov/nchs/ populations from the censuses in those years as
nvss.htm. of April 1. Birth rates for 20012009 were revised
based on the 2000 and 2010 censuses. Birth rates for
Youth Risk Behavior Survey (YRBS)Prior to 1999, the 2011 and subsequent years were computed using
1977 OMB Standards were used. Respondents could 2010-based postcensal estimates. The population
select only one of the following categories: white (not estimates have been provided by the U.S. Census
Hispanic), black (not Hispanic), Hispanic or Latino, Bureau and have been modified to be consistent
Asian or Pacific Islander, American Indian or Alaska with OMB racial categories as of 1977 and historical
categories for birth data. Beginning in 1997, the birth
Native, or other. Beginning in 1999, the 1997 OMB
rate for the maternal age group 4549 includes data
Standards were used for race-specific estimates, and
for mothers aged 5054 in the numerator and is
respondents were given the option of selecting more
based on the population of women aged 4549 in the
than one category to describe their race and ethnicity.
denominator. Birth rates are expressed as the number
Between 1999 and 2003, students were asked a single
of live births per 1,000 population. The rate may be
question about race and Hispanic origin, with the
restricted to births to women of specific age, race,
option of choosing more than one of the following
marital status, or geographic location (specific rate), or
responses: white, black or African American, Hispanic it may be related to the entire population (crude rate).
or Latino, Asian, Native Hawaiian or Other Pacific
Islander, or American Indian or Alaska Native. In 2005, Fertility rate is the total number of live births, regardless
students were asked a question about Hispanic origin of the age of the mother, per 1,000 women of
(Are you Hispanic or Latino?) and a second separate reproductive age (aged 1544). Beginning in 1997, the
question about race that included the option of birth rate for the maternal age group 4549 includes
selecting more than one of the following categories: data for mothers aged 5054 in the numerator and is
American Indian or Alaska Native, Asian, black or based on the population of women aged 4549 in the
African American, Native Hawaiian or Other Pacific denominator.
Islander, or white. Because of the differences between
457 Appendix II. Definitions and Methods Health, United States, 2016
Death and related rates fetal deaths plus infant deaths within 7 days of birth,
divided by the number of live births, times 1,000.
Death rate is calculated by dividing the number
of deaths in a population in a year by the midyear Visit rate
resident population. For census years, rates are
based on unrounded census counts of the resident Visit rate is a basic measure of service utilization
population as of April 1. For the noncensus years 1981 for event-based data. Examples of events include
1989, rates are based on national estimates of the
physician office visits with drugs provided, or
resident population as of July 1, rounded to thousands.
hospital discharges. In the visit rate calculation, the
Rounded population estimates for 10-year age groups
numerator is the number of estimated events, and
are calculated by summing unrounded population
the denominator is the corresponding U.S. population
estimates before rounding to thousands. Starting
estimate for those who possibly could have had events
in 1991, rates are based on unrounded national
during a given period of time. The interpretation is
population estimates. Rates for the Hispanic and non-
that for every person in the population there were,
Hispanic white populations in each year are based on
on average, x events. It does not mean that x persons
unrounded state population estimates for states in the
in the population had events, because some persons
Hispanic reporting area. Death rates are expressed as
in the population had no events while others had
the number of deaths per 100,000 resident population.
multiple events. The only exception is when an
The rate may be restricted to deaths in specific age,
event can occur just once for a person (e.g., if an
race, sex, or geographic groups or from specific causes
appendectomy is performed during a hospital stay).
of death (specific rate), or it may be related to the
entire population (crude rate). (Also see Appendix I, The visit rate is best used to compare utilization across
Population Census and Population Estimates.) various subgroups of interest, such as age or race
groups or geographic regions.
Birth cohort infant mortality rates are based on the
birth cohort linked birth and infant death files and are RegionSee Appendix II, Geographic region.
computed as the number of deaths under age 1 year
to members of the birth cohort, divided by the number
Registered hospitalSee Appendix II, Hospital.
of live births, times 1,000. (Also see Appendix II, Birth
cohort.)
Registration areaThe United States has separate
registration areas for birth, death, marriage, and divorce
Fetal mortality rate is the number of fetal deaths with
statistics. In general, registration areas correspond to
stated or presumed gestation of 20 weeks or more,
states and include two separate registration areas for
divided by the sum of live births plus fetal deaths,
D.C. and New York City. The term reporting area may be
times 1,000.
used interchangeably with the term registration area.
All registration areas have adopted laws that require
Infant mortality rate is based on period files and is
registration of births and deaths and the reporting of fetal
calculated by dividing the number of infant deaths
deaths. It is believed that more than 99% of births and
during a calendar year by the number of live births
deaths occurring in this country are registered.
reported in the same year. It is expressed as the
number of infant deaths per 1,000 live births. Neonatal
mortality rate is the number of deaths among infants The death registration area was established in 1900 with
under age 28 days per 1,000 live births. Postneonatal 10 states and D.C., and the birth registration area was
mortality rate is the number of infant deaths that occur established in 1915, also with 10 states and D.C. Beginning
between 28 days to under 1 year after birth, per 1,000 in 1933, all states were included in the birth and death
live births. (Also see Appendix II, Infant death.) registration areas. The specific states added year by year
are shown in: Hetzel AM. History and organization of the
Late fetal mortality rate is the number of fetal deaths vital statistics system. Hyattsville, MD: NCHS; 1997. Available
with stated or presumed gestation of 28 weeks or from: http://www.cdc.gov/nchs/data/misc/usvss.pdf.
more, divided by the sum of live births plus late fetal Currently, Puerto Rico, the U.S. Virgin Islands, and Guam each
deaths, times 1,000. (Also see Appendix II, Gestation.) constitute a separate registration area, although their data
are not included in statistical tabulations of U.S. resident
Perinatal mortality rates and ratios relate to the period data. (Also see Appendix II, Reporting area.)
surrounding the birth event. Rates and ratios are based
on events reported in a calendar year. Although several Relative standard error (RSE)RSE is a measure of an
different perinatal mortality definitions exist, the estimates reliability. The RSE of an estimate is obtained by
perinatal definition used in Health, United States (and dividing the standard error of the estimate, SE(r), by the
used most commonly for international comparisons) estimate itself, r. This quantity is expressed as a percentage
is the sum of late fetal deaths at 28 weeks of gestation of the estimate and is calculated as follows:
or more plus infant deaths within 7 days of birth,
divided by the sum of live births plus late fetal deaths, RSE = 100 x [SE(r)/(r)]
times 1,000. Perinatal mortality ratio is the sum of late
458 Appendix II. Definitions and Methods Health, United States, 2016
Estimates with large RSEs are considered unreliable. In During the past 30 days, how often did you feel:
Health, United States, most statistics with large RSEs are
preceded by an asterisk or are not presented. The criteria for So sad that nothing could cheer you up?
evaluating RSEs is discussed in the footnotes accompanying
each table. Nervous?
Restless or fidgety?
Relative survival rateThe relative survival rate is the ratio
Hopeless?
of the observed survival rate for the patient group to the
expected survival rate for persons in the general population That everything was an effort?
similar to the patient group with respect to age, sex, race, Worthless?
and calendar year of observation. The 5-year relative survival
rate estimates the proportion of cancer patients who have Possible answers are All of the time (4 points), Most of the
survived their cancer 5 years after diagnosis. Because more time (3 points), Some of the time (2 points), A little of the
than one-half of all cancers occur in persons aged 65 and time (1 point), and None of the time (0 points).
over, many of these individuals die of other causes with
no evidence of recurrence of their cancer. However, by To score the K6, the points are added together, yielding
adjusting observed survival for the normal life expectancy of a possible total of 024 points. A threshold of 13 points
the general population of the same age, the relative survival or more is used to define serious psychological distress.
rate gives a more specific estimate of the chance of surviving Persons answering Some of the time to all six questions
the effects of cancer alone. would not reach the threshold for serious psychological
distress because they would need to answer Most of the
Reporting areaIn the National Vital Statistics System, time to at least one item to achieve a score of 13. Only
the reporting area for such basic items on the birth and respondents who answered all six psychological distress
death certificates as age, race, and sex is based on data questions would have a computed K6 score for analysis. The
from residents of all 50 states in the United States, D.C., version of the K6 used in NHIS provides 1-month prevalence
and New York City. The term reporting area may be used rates because the reference period is the past 30 days.
interchangeably with the term registration area. (Also see For more information, see: Kessler RC, Barker PR, Colpe LJ,
Appendix II, Registration area; and Appendix I, National Vital Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious
Statistics System [NVSS].) mental illness in the general population. Arch Gen Psychiatry
2003;60(2):1849. (Also see Appendix II, Basic actions
Resident, health facilityIn the Centers for Medicare difficulty.)
& Medicaid Services Quality Improvement Evaluation
System (QIES) (formerly the Online Survey Certification Starting in 2013, the K6 questions were moved to the adult
and Reporting [OSCAR]) database, all residents in certified selected items section of the Sample Adult questionnaire.
facilities are counted on the day of certification inspection. Observed differences between the 2012 and earlier
estimates and 2013 and later estimates may be partially
Resident populationSee Appendix II, Population. or fully attributable to this change in question placement
within the Sample Adult questionnaire.
RuralSee Appendix II, Urbanization.
Short-stay hospitalSee Appendix II, Hospital.
Self-assessment of healthSee Appendix II, Health status,
respondent-assessed. Skilled nursing facilitySee Appendix II, Nursing home.
Serious psychological distressThe K6 mental health SmokerSee Appendix II, Cigarette smoking.
screening instrument is a measure of psychological distress
associated with unspecified but potentially diagnosable Special hospitalSee Appendix II, Hospital.
mental illness that may result in a higher risk for disability
and higher utilization of health services. In the National Substance useSubstance use refers to the use of selected
Health Interview Survey, the K6 questions were asked of substances, including alcohol, tobacco products, drugs,
adults aged 18 and over. The K6 is designed to identify inhalants, and other substances that can be consumed,
persons with serious psychological distress, using as few inhaled, injected, or otherwise absorbed into the body with
questions as possible. The six items included in the K6 are: possible dependence and other detrimental effects. (Also
see Appendix II, Illicit drug use.)
459 Appendix II. Definitions and Methods Health, United States, 2016
Monitoring the Future (MTF) StudyMTF collects SurgerySee Appendix II, Outpatient surgery; Procedure.
information on the use of selected substances by
using self-completed questionnaires in a school-based Surgical specialtySee Appendix II, Physician specialty.
survey of secondary school students. MTF has tracked
12th graders illicit drug use and attitudes toward drugs Tobacco useSee Appendix II, Cigarette smoking.
since 1975. In 1991, 8th and 10th graders were added
to the study. The survey includes questions on abuse UninsuredBroadly, persons are considered uninsured
of substances including (but not limited to) marijuana, if they do not have coverage under private health
inhalants, other illegal drugs, alcohol, cigarettes, insurance, Medicare, Medicaid, public assistance (through
and other tobacco products. (Also see Appendix I, 1996), Childrens Health Insurance Program (CHIP), a
Monitoring the Future [MTF] Study.) state-sponsored or other government-sponsored plan or
program, or a military health plan. Because of differences
National Survey on Drug Use & Health (NSDUH)NSDUH in methodology, question wording, and recall period,
conducts in-person, computer-assisted interviews of a estimates from different sources may vary and are not
sample of individuals aged 12 and over at their place of directly comparable. For more information, see: Health
residence. For illicit drug use, alcohol use, and tobacco insurance measurement: Differences by data source.
use, information is collected about use in the lifetime, Available from: https://www2.census.gov/programs
past year, and past month. However, only estimates of surveys/demo/visualizations/p60/257/health_insurance_
use in the past month are presented in Health, United measurement.pdf.
States. For illicit drug use, respondents in NSDUH
are asked about use of marijuana/hashish, cocaine
American Community Survey (ACS)In ACS, persons
(including crack), inhalants, hallucinogens, heroin,
are considered uninsured if they do not have coverage
and misuse of prescription-type psychotherapeutic
through private health insurance, Medicare, Medicaid,
drugs (pain relievers, tranquilizers, stimulants, and
CHIP, military/TRICARE or veterans coverage, another
sedatives). A series of questions is asked about
government program, or other insurance. Persons with
each substance: Have you ever, even once, used
only Indian Health Service coverage are considered
[substance]?, and How long has it been since you last
used [substance]? Numerous probes and checks are uninsured. The questions on health insurance are
included in the computer-assisted interview system. administered throughout the year and ask about
Starting in 2013, information about marijuana use current health insurance coverage as of the day of the
that was recommended by a doctor or other health interview.
care professional has been collected; however, any
reported marijuana use is classified as illicit drug use. National Health Interview Survey (NHIS)In NHIS, the
Summary measures, such as current illicit drug use, are uninsured are persons who do not have coverage
produced. Starting in 2015, changes in measurement under private health insurance, Medicare, Medicaid,
for 7 of the 10 illicit drug categorieshallucinogens, public assistance (through 1996), CHIP, a state-
inhalants, methamphetamine, and the misuse of sponsored health plan, other government-sponsored
prescription pain relievers, tranquilizers, stimulants, programs, or a military health plan. Persons with
and sedativesmay have affected the comparability only Indian Health Service coverage are considered
of the measurement of these illicit drugs and any uninsured. Estimates for the uninsured are shown
illicit drug between 2015 and prior years. (Also see only for the population under age 65. Estimates of
Appendix II, Alcohol consumption; Cigarette smoking; the percentage of persons who are uninsured based
Illicit drug use; and Appendix I, National Survey on on NHIS may differ slightly from those based on the
Drug Use & Health [NSDUH].) March Current Population Survey or the American
Community Survey because of differences in survey
Suicidal ideationSuicidal ideation means having questions, recall period, and other aspects of survey
thoughts of suicide or of taking action to end ones own methodology.
life. Suicidal ideation includes all thoughts of suicide,
both when the thoughts include a plan to commit suicide Survey respondents may be covered by health
and when they do not include a plan. Suicidal ideation is insurance at the time of interview but may have
measured in the Youth Risk Behavior Survey by the following experienced one or more lapses in coverage during
three questions: During the past 12 months, did you ever the year prior to interview. Starting with Health, United
seriously consider attempting suicide?, During the past 12 States, 2006, NHIS estimates for people with health
months, how many times did you actually attempt suicide?,
insurance coverage for all 12 months prior to interview,
for those who were uninsured for any period up to
and If you attempted suicide during the past 12 months,
12 months, and for those who were uninsured for
did any attempt result in an injury, poisoning, or overdose
more than 12 months were added as stub variables to
that had to be treated by a doctor or nurse? For more
selected tables. (Also see Appendix II, Health insurance
information, see: http://www.cdc.gov/HealthyYouth/yrbs/
coverage.)
index.htm.
460 Appendix II. Definitions and Methods Health, United States, 2016
UrbanizationUrbanization is the degree of urban (city The currently recommended childhood vaccination
like) character of a particular geographic area. Urbanization schedule includes vaccines that prevent infectious diseases
can be measured in a variety of ways. In Health, United States, including hepatitis A and B, diphtheria, tetanus toxoids,
the two measures currently used to categorize counties acellular pertussis (whooping cough), measles, mumps,
by urbanization level are the Office of Management and rubella (German measles), polio, varicella (chickenpox),
Budgets (OMB) metropolitan and micropolitan statistical and some forms of meningitis (HIB), influenza, and
area classification and the 2013 NCHS UrbanRural pneumococcal disease. In February 2006, a rotavirus vaccine
Classification Scheme for Counties. For more information (RotaTeq) was licensed for use in U.S. infants.
on the OMB classification of counties, see Appendix II,
Metropolitan statistical area (MSA); Micropolitan statistical A vaccine that protects against the four types of human
area. papillomavirus (HPV) that cause most cervical cancers and
genital warts was marketed starting in 2006 and is now
The 2013 UrbanRural Classification Scheme is based on the available for both females and males. Initially, the vaccine
February 2013 OMB delineation of MSAs and micropolitan was recommended for girls aged 11 and 12 and for girls
statistical areas, 2012 postcensal estimates of county and women aged 1326 who have not yet been vaccinated
and place population, and county-level data on selected or completed the vaccine series. In October 2011, HPV
settlement density, socioeconomic, and demographic vaccination also was recommended for males aged 11 and
variables from Census 2010. This is an updated version 12. Further information is available from: http://www.cdc.
of NCHS earlier scheme, the 2006 NCHS UrbanRural gov/mmwr/preview/mmwrhtml/mm6050a3.htm.
Classification Scheme for Counties. The six categories of the
NCHS scheme are large central metro (inner-city counties In addition to keeping current with the vaccines listed
of MSAs of 1 million or more population), large fringe above, and annual influenza vaccination, some additional
metro (suburban counties of MSAs of 1 million or more vaccinations are recommended for older adults, persons
population), medium metro (counties of MSAs of 250,000 with specific health conditions, or health care workers
999,999 population), small metro (counties of MSAs with less who are likely to be exposed to infectious persons. For
than 250,000 population), nonmetropolitan micropolitan example, Herpes zoster vaccination is recommended for
statistical areas, and nonmetropolitan noncore. For more
adults aged 60 and over, and pneumococcal vaccination is
information on the classification scheme, see: https://www.
recommended for adults aged 65 and over and persons with
cdc.gov/nchs/data_access/urban_rural.htm.
specific health conditions.
Usual source of careUsual source of care was measured
in the National Health Interview Survey in 1993 and 1994 For a full discussion of recommended vaccination schedules
by asking the respondent, Is there a particular person or by age and population, see CDCs vaccination and
place that [person] usually goes to when [person] is sick immunization website at: http://www.cdc.gov/vaccines/
or needs advice about [persons] health? In the 1995 and schedules/index.html.
1996 NHIS, the respondent was asked, Is there one doctor,
person, or place that [person] usually goes to when [person] Influenza vaccinationIn the National Health Interview
is sick or needs advice about health? Starting in 1997, Survey, questions concerning influenza vaccination
the respondent was asked, Is there a place that [person] differed slightly across the survey years. Prior to
usually goes when [he/she] is sick or you need advice September 2003, respondents were asked, During the
about [his/her] health? Persons who report the emergency past 12 months, have you had a flu shot? A flu shot is
department as their usual source of care are defined in usually given in the fall and protects against influenza
Health, United States as having no usual source of care. for the flu season. Starting in September 2003,
respondents were asked about influenza vaccination
VaccinationVaccinations, or immunizations, work by by nasal spray (sometimes called by the brand name
stimulating the immune systemthe natural disease- FluMist) during the past 12 months, in addition to the
fighting system of the body. A healthy immune system is question regarding the flu shot. Starting with 2005
able to recognize invading bacteria and viruses and produce data, receipt of nasal spray or a flu shot was included
substances (antibodies) to destroy or disable these invaders. in the calculation of influenza vaccination estimates
Vaccinations prepare the immune system to ward off a presented in Health, United States. Starting with
disease. In addition to the initial immunization process, the
2010 data, additional questions were asked about
effectiveness of some immunizations can be improved by
the receipt of the H1N1 flu shot and spray, including
periodic repeat injections or boosters. Vaccines are among
month and year received. These H1N1 questions and
the most successful and cost-effective public health tools
available for reducing morbidity and mortality from vaccine- the original seasonal flu questions were asked only in
preventable diseases. For a comprehensive list of vaccine- quarters 1 and 2 and the first several weeks of quarter
preventable diseases, see: http://www.cdc.gov/vaccines/ 3. Starting August 11, 2010, revised flu vaccination
vpd-vac/vpd-list.htm and http://www.cdc.gov/vaccines/ questions replaced all flu vaccination questions fielded
spec-grps/default.htm. earlier in 2010 and were used in 2011. The revised
questions reflect the introduction of a new combined
flu vaccination that protects against both the seasonal
461 Appendix II. Definitions and Methods Health, United States, 2016
and H1N1 strains. For more information regarding the age 65. For more information, see: CDC. Premature mortality
influenza questions that were introduced in 2010, see: in the United States: Public health issues in the use of
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_ years of potential life lost. MMWR 1986;35(SS02):1S11S.
Documentation/NHIS/2010/srvydesc.pdf. Available from: http://www.cdc.gov/mmwr/preview/
mmwrhtml/00001773.htm.
The prevalence of influenza vaccination during the
past 12 months may differ from season-specific
coverage, and estimates from different data sources
may differ (additional estimates are available from:
http://www.cdc.gov/flu/fluvaxview/). See: CDC.
Surveillance of influenza vaccination coverage
United States, 200708 through 201112 influenza
seasons. MMWR 2013;62(ss04):129. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/
ss6204a1.htm?s_cid=ss6204a1_w.
462 Appendix II. Definitions and Methods Health, United States, 2016
Index
Index
(Numbers are table and figure numbers)
A ACon.
Table/Figure (F) Table/Figure (F)
Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
American Indian or Alaska Native populationCon.
Access to care (see also Dental visits; Emergency department visits; Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Health insurance; Hospital utilization; Injuries; Unmet need for Occupational injury deaths . . . . . . . . . . . . . . . . . . . . .32
Activities of daily living (ADL), see Basic actions difficulty; Serious psychological distress . . . . . . . . . . . . . . . . . . .46
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Death rates, selected causes . . . . . 17, 18, 22, 23, 24, 25, 26, 27,
Death rates, selected causes . . . . . 17, 18, 22, 23, 24, 25, 26, 27,
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Cocaine use. . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F2
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . .27
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Drugs, prescription, use in past 30 days . . . . . . . . . . . . . .79
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . 3
Emotional or behavioral difficulties . . . . . . . . . . . . . . . . .35
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Expenses, health care . . . . . . . . . . . . . . . . . . . . .97, 98
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Health insurance . . . . . . . . . . . . . . 102, 103, 104, 105, 106
Basic actions difficulty. . . . . . 41, 42, 45, 49, 57, 62, 63, 65, 68, 69,
Hospital utilization, outpatient department . . . . . . . . . . 76, 108
70, 71, 72, 74, 78, 81, 102, 103, 104, 105
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Births
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Age of mother. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Births, number . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
Fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F2
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . 3
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . 53, 59, F11
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2, F4
Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Deaths and death rates . . . . . . . . . . .17, 19, 20, 24, 25, 26, F8
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . 3, 4
Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F16
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . .66, 67
Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . .53, 55
subgroups.
Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Cost, see Employers costs for health insurance.
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
D
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Contraception. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Death rates, selected causes . . . . . . . 20, 22, 23, 24, 27, 28, 29,
Years of potential life lost [YPLL])
30, 31, 32
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Basic actions difficulty . . . . . . 41, 42, 45, 49, 57, 62, 63, 65, 68,
Hospital care expenditures; Medicaid; Medicare; Nursing homes
69, 70, 71, 72, 74, 78, 81, 102, 103, 104, 105
expenditures; Physician services expenditures; Prescription
Complex activity limitation . . . . . . 41, 42, 45, 49, 57, 62, 63, 65,
Type of expenditure. . . . . . . . . . . . . . . . . 94, 95, F23, F24
68, 69, 70, 71, 72, 74, 78, 81, 102, 103, 104, 105
Type of sponsor. . . . . . . . . . . . . . . . . . . . . . . . . . 100
E G
Geographic region
Education
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . .68, 69
Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Exercise, see Physical activity. Health care expenses, see Expenses, health care.
Expenditures, national health (see also Consumer Price Index [CPI]; Health care utilization . . . . 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74,
Hospital care expenditures; Medicaid; Medicare; Nursing homes 75, 76, 77, 78, 79, 80, 81, 82, F16
expenditures; Physician services expenditures; Prescription Health expenditures, national, see Expenditures, national health.
expenditures; Substance use; Veterans' medical care)
Health insurance (see also Access to care; Emergency department
Heart disease
Limitation of activity . . . . . . . . . . . . . . . . . . . . . . . 108
Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Physical activity. . . . . . . . . . . . . . . . . . . . . . . . . . .57
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F2
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . .38
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . 5, 6
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . .52
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Violence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Contraception. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Rican population)
Death rates, selected causes . . . . . . . 17, 18, 22, 23, 24, 25, 26,
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Deaths and death rates . . . . . . . . . . . . . . . . . . .17, 19, 20
visits; Medicaid; Medicare; Veterans' medical care) Lyme disease, see Diseases, notifiable.
Admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Average length of stay . . . . . . . . . . . . . . . . . . . . 82, 112 M
Beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F20
Cost for procedures or surgeries . . . . . . . . . . . . . . . . . .96 Malignant neoplasms, see Cancer.
Inpatient stays . . . . . . . . . . . . . . . . . . . . . . . . . . F18 Mammography . . . . . . . . . . . . . . . . . . . . . . . . . 70, F19
Occupancy rate. . . . . . . . . . . . . . . . . . . . . . . . . . F20 Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . .50, 51
Outpatient department . . . . . . . . . . . . . . . . . . 76, 82, 108 Marital status . . . . . . . . . . . . . . . . . 102, 103, 104, 105, 106
Race and Hispanic origin . . . . . . . . . . . . . . . . . . . 81, 108 Maternal health, see Women's health.
Hospitals (see also Mental health; Nursing homes) Measles, see Diseases, notifiable; Vaccinations.
Beds . . . . . . . . . . . . . . . . . . . . . . . . . . . 89, 90, F20 Medicaid (see also Health insurance)
I
Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . 95, 100
International. . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Expenses, health care . . . . . . . . . . . . . . . . . . . . . . .97
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Hospital utilization . . . . . . . . . . . . . . . . . . . . . . . . 112
Deaths . . . . . . . . . . . . . . . . . . . . . . . . .17, 18, 19, 20 Race and Hispanic origin . . . . . . . . . . . . . . . . . . 106, 108
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Access to care . . . . . . . . . . . . . . . . . . . . . . .62, 63, 65
Death rates; Motor vehicle-related injuries; Occupational injuries; Back pain, low . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Unintentional injuries.
Basic actions difficulty . . . . . . . . . . . . . . . . . . . . . . .42
utilization.
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . .38
Ischemic heart disease, see Heart disease. Cigarette smoking . . . . . . . . . . . . . . . . 47, 48, 49, 50, F10
Contraception. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Kidney disease, see Nephritis, nephrotic syndrome, and nephrosis. Death rates, all causes . . . . . . . . . . . . . . . . . . . . .17, 21
Death rates, selected causes . . . . . 17, 18, 22, 23, 24, 25, 27, 28,
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . .60
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F1
Health status, respondent-assessed . . . . . . . . . . . . . . . .45
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F4
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . .68, 69
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Psychiatrists . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Serious psychological distress . . . . . . . . . . . . . . . . . . .46
Visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F16
Unmarried mother . . . . . . . . . . . . . . . . . . . . . . . . . 4
Metropolitan/nonmetropolitan data
Unmet need. . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87
Nursing homes
Serious psychological distress . . . . . . . . . . . . . . . . . . .46
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F8
Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F16
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . .68, 69
Access to care . . . . . . . . . . . . . .
. . . . . . . . . . .63, 65
Overweight . . . . . . . . . . . . . . . . . . . . . . . . . . . .53, 58
Cancer, respondent-reported . . . . . . .
. . . . . . . . . . . . .38
Cholesterol . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .55
P
Chronic conditions, selected . . . . . . .
. . . . . . . . . . . . .39
Cigarette smoking . . . . . . . . . . . .
. . . . . . . . . . .47, 49
Pap smear (Pap test) . . . . . . . . . . . . . . . . . . . . . . . . .71
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Physician utilization . . . . . . . . . . . . . . . . . . . . . . . .76, 77
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . .35
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . .38
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Sterilization, see Contraception.
Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Substance use (see also Drug use, illicit)
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . 2, F4
T
Serious psychological distress . . . . . . . . . . . . . . . . . . .46
Unmet need for medical care, dental care, prescription drugs . . . .63
Births . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
R
W
Race, see specific racial groups.
S Allergy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . .19, 20
Basic actions difficulty . . . . . . . . . . . . . . . . . . . . . . .42
Birth rates. . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F9
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Birthweight, low. . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55
Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Cigarette smoking . . . . . . . . . . . . .
. . . .47, 48, 49, 50, 51
Unmet need. . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Cocaine use. . . . . . . . . . . . . . . . .
. . . . . . . . . . . .51
Vaccinations . . . . . . . . . . . . . . . . . . . . . .66, 67, 68, 69
Contraception. . . . . . . . . . . . . . . .
. . . . . . . . . . . . 8
Years of potential life lost (YPLL) . . . . . . . . . . . . . . . . . .18
. .
Glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . .40
Colorectal tests or procedures . . . . . .
. . . . . . . . . . . . .72
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Doctor visits . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Emergency department visits. . . . . . . . . . . . . . . .74, 75, 76
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F2
Mammography . . . . . . . . . . . . . . . . . . . . . . . . 70, F19
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . 3
Pap smear (Pap test) . . . . . . . . . . . . . . . . . . . . . . . .71
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Physical activity. . . . . . . . . . . . . . . . . . . . . . . . . . .57
Population, resident . . . . . . . . . . . . . . . . . . . . . . 1, F1
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2, F4
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . 3
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . 4
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . .68, 69
Y
Years of potential life lost (YPLL) . . . . . . . . . . . . . . . . . . .18
Young adults (aged 1925) . . . . . . . . . 62, 63, 102, 103, 104, 105